Provider Demographics
NPI:1336132216
Name:FRAZIER, JAMES EDWARD II
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:FRAZIER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2755
Mailing Address - Country:US
Mailing Address - Phone:804-649-8765
Mailing Address - Fax:804-649-8766
Practice Address - Street 1:1510 N 28TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5332
Practice Address - Country:US
Practice Address - Phone:804-649-8765
Practice Address - Fax:804-649-8766
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist