Provider Demographics
NPI:1407945942
Name:FRAZIER, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:FRAZIER
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 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:200 E CHESTNUT ST
Practice Address - Street 2:SVS BLDG STE 303
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1831
Practice Address - Country:US
Practice Address - Phone:502-629-5552
Practice Address - Fax:502-629-3132
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34865207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
2233577OtherUNITED HEALTH CARE
KY2948557OtherAETNA HMO ONLY
587286OtherANTHEM/NORTON
P00641375OtherRAILROAD MEDICARE
KY00533069OtherNMF/KY MEDICARE
KY64055114Medicaid
KY7134413OtherAETNA
KY000000332133OtherANTHEM
2179185OtherFIRST HEALTH
KY64055114OtherMEDICAID-KY NORTON
50020904OtherPASSPORT/NORTON
200394090OtherIN MAID/NORTON
KY50004780OtherPASSPORT
KY6294877OtherCIGNA
KY2446132000OtherPASSPORT ADVANTAGE
6294877OtherCIGNA/NORTON
P00135439OtherMEDICARE RR
099308OtherSIHO/NORTON
IN200394090Medicaid
2233577OtherUNITED HEALTH CARE
KY64055114Medicaid
KY00533069Medicare PIN