Provider Demographics
NPI:1982663241
Name:FRAZIER, KATHALYN G (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHALYN
Middle Name:G
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 RAINIER DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239
Mailing Address - Country:US
Mailing Address - Phone:724-325-1958
Mailing Address - Fax:412-244-4992
Practice Address - Street 1:7227 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1814
Practice Address - Country:US
Practice Address - Phone:412-244-4700
Practice Address - Fax:412-244-7797
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003182L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1115442Medicaid
PA1115442Medicaid
PA1115442Medicaid