Provider Demographics
NPI:1326108473
Name:FRAZEE, TERRILL SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRILL
Middle Name:SCOTT
Last Name:FRAZEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6061
Mailing Address - Country:US
Mailing Address - Phone:405-293-9345
Mailing Address - Fax:405-293-9347
Practice Address - Street 1:1809 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6061
Practice Address - Country:US
Practice Address - Phone:405-293-9345
Practice Address - Fax:405-293-9347
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5905646OtherAETNA ID #