Provider Demographics
NPI:1720075948
Name:FRIERSON, SABRINA DEBRA (MD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:DEBRA
Last Name:FRIERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:DEBRA
Other - Last Name:TRIEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5225
Mailing Address - Fax:740-446-5956
Practice Address - Street 1:90 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5225
Practice Address - Fax:740-446-5956
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125711208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ48224ZOtherMEDICARE IDENTIFICATION #
CA020053720OtherRAILROAD MEDICARE
CAH54041Medicare UPIN
CAZZZ48224ZOtherMEDICARE IDENTIFICATION #