Provider Demographics
NPI:1730144221
Name:FRIERSON, JAMES ALAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:FRIERSON
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 1:1000 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7667
Mailing Address - Country:US
Mailing Address - Phone:541-773-3688
Mailing Address - Fax:541-773-3125
Practice Address - Street 1:1322 E MCANDREWS RD STE 202
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6177
Practice Address - Country:US
Practice Address - Phone:541-773-3688
Practice Address - Fax:541-773-3125
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD133302080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278028Medicaid
ORC92668Medicare UPIN