Provider Demographics
NPI:1942255179
Name:FRAZIER, CHAD ALLEN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:ALLEN
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BESSEMER ROAD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35208-4712
Mailing Address - Country:US
Mailing Address - Phone:205-786-3409
Mailing Address - Fax:205-787-2162
Practice Address - Street 1:2200 BESSEMER ROAD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35208-4712
Practice Address - Country:US
Practice Address - Phone:205-786-3409
Practice Address - Fax:205-787-2162
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSA60TA645152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-23355OtherBC/BS OF ALABAMA
AL515-23355OtherBC/BS OF ALABAMA