Provider Demographics
NPI:1346218161
Name:FRANTZ, FRAZIER W (MD)
Entity Type:Individual
Prefix:DR
First Name:FRAZIER
Middle Name:W
Last Name:FRANTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741593
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1593
Mailing Address - Country:US
Mailing Address - Phone:757-668-7703
Mailing Address - Fax:757-668-8860
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7703
Practice Address - Fax:757-668-8860
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046265208600000X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7906293Medicaid
VA006702929Medicaid
VAC06141Medicare PIN