Provider Demographics
NPI:1962454520
Name:JONES, FRAZIER KAVANUAGH (MD)
Entity Type:Individual
Prefix:DR
First Name:FRAZIER
Middle Name:KAVANUAGH
Last Name:JONES
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 1:121 N 20TH ST
Mailing Address - Street 2:P.O. BOX 2125
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5457
Mailing Address - Country:US
Mailing Address - Phone:334-749-8303
Mailing Address - Fax:334-745-5243
Practice Address - Street 1:121 N 20TH ST
Practice Address - Street 2:#18
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5449
Practice Address - Country:US
Practice Address - Phone:334-749-8303
Practice Address - Fax:334-745-5243
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00016727207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51077709OtherBLUE CROSS & BLUE SHIELD
AL000098560Medicaid
AL000077708Medicaid
AL000077709Medicaid
AL51077708OtherBLUE CROSS & BLUE SHIELD
AL51077709OtherBLUE CROSS & BLUE SHIELD
AL000098560Medicaid
AL000077708Medicaid