Provider Demographics
NPI:1740495662
Name:FRAZIER, MASON (MD)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:2000 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2110
Practice Address - Country:US
Practice Address - Phone:205-801-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL262102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051107197OtherBCBS
AL1811994015Medicaid
ALZ01256OtherVIVA
AL051107193OtherBCBS
ALP00858707OtherRAILROAD MEDICARE
MS05385312Medicaid
AL051107198OtherBCBS
AL119492Medicaid
AL119499Medicaid
AL119501Medicaid
AL051107199OtherBCBS
AL119489Medicaid
AL119496Medicaid
AL119502Medicaid
AL119504Medicaid
AL051107194OtherBCBS
AL051107195OtherBCBS
AL051107196OtherBCBS
AL051107200OtherBCBS
AL119491Medicaid
AL119497Medicaid
AL119505Medicaid
AL051107192OtherBCBS
AL051107201OtherBCBS
MS05385312Medicaid
AL051107193OtherBCBS
AL119505Medicaid