Provider Demographics
NPI:1700069648
Name:FRAZIER, WILLIAM DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DAVID
Last Name:FRAZIER
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 1:1 DOCTORS DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605
Mailing Address - Country:US
Mailing Address - Phone:864-572-7001
Mailing Address - Fax:864-412-0436
Practice Address - Street 1:1 DOCTORS DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4266
Practice Address - Country:US
Practice Address - Phone:864-572-7001
Practice Address - Fax:864-412-0436
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31806207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC318061Medicaid
NC41167BMedicare UPIN
SCAA37617951Medicare PIN