Provider Demographics
NPI:1790065472
Name:FRAYSER, JAMES SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:SCOTT
Last Name:FRAYSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2424 E 21ST ST
Mailing Address - Street 2:SUITE 425
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1711
Mailing Address - Country:US
Mailing Address - Phone:918-608-1526
Mailing Address - Fax:918-935-3544
Practice Address - Street 1:2424 E 21ST ST
Practice Address - Street 2:SUITE 425
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1711
Practice Address - Country:US
Practice Address - Phone:918-608-1526
Practice Address - Fax:918-935-3544
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19247207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine