Provider Demographics
NPI:1659613412
Name:FRAZIER, ROBERT ELIGA II (RPH, PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ELIGA
Last Name:FRAZIER
Suffix:II
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 MCGINNIS FERRY RD
Mailing Address - Street 2:APT 1114
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8311
Mailing Address - Country:US
Mailing Address - Phone:405-638-1965
Mailing Address - Fax:
Practice Address - Street 1:1490 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4674
Practice Address - Country:US
Practice Address - Phone:770-921-9976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist