Provider Demographics
NPI:1780681809
Name:FRAZER, JOSEPH III (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FRAZER
Suffix:III
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 1:800 OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NH
Mailing Address - Zip Code:03870-2844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 GRIFFIN RD
Practice Address - Street 2:SUITE A
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7113
Practice Address - Country:US
Practice Address - Phone:603-436-7897
Practice Address - Fax:603-436-7855
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6062207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81030856Medicaid
NH0105715Y0NH01OtherANTHEM NH ID #
NHRE0685Medicare ID - Type Unspecified
NH0105715Y0NH01OtherANTHEM NH ID #