Provider Demographics
NPI:1639118847
Name:FRAZIER, WILLIAM HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
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 2569
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30514
Mailing Address - Country:US
Mailing Address - Phone:706-439-6486
Mailing Address - Fax:706-745-7271
Practice Address - Street 1:123 WEAVER ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512
Practice Address - Country:US
Practice Address - Phone:706-439-6486
Practice Address - Fax:706-745-7271
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 405292086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFS0991580OtherCHAMPUS
FL0673056-00Medicaid
FLFS0991580OtherCHAMPUS
FL0673056-00Medicaid