Provider Demographics
NPI:1669639092
Name:FRASER, DOUGLAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:R
Last Name:FRASER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1701 W CHARLESTON BLVD
Mailing Address - Street 2:#490
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2325
Mailing Address - Country:US
Mailing Address - Phone:702-671-2201
Mailing Address - Fax:702-382-5388
Practice Address - Street 1:1707 W CHARLESTON BLVD
Practice Address - Street 2:#160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2351
Practice Address - Country:US
Practice Address - Phone:702-671-5150
Practice Address - Fax:702-384-6493
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2022-06-16
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Provider Licenses
StateLicense IDTaxonomies
NV148232086S0127X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery