Provider Demographics
NPI:1487015301
Name:FRASE, LOUIS HARVEY
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:HARVEY
Last Name:FRASE
Suffix:
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 1:2516 E PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-4133
Mailing Address - Country:US
Mailing Address - Phone:715-563-1322
Mailing Address - Fax:715-514-2157
Practice Address - Street 1:2516 E PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-4133
Practice Address - Country:US
Practice Address - Phone:715-563-1322
Practice Address - Fax:715-514-2157
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-20
Last Update Date:2016-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17690207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine