Provider Demographics
NPI:1821817172
Name:FRAZIER, ALBERT A SR
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:A
Last Name:FRAZIER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 HARTMAN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-1936
Mailing Address - Country:US
Mailing Address - Phone:419-378-2768
Mailing Address - Fax:
Practice Address - Street 1:3014 HARTMAN ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-1936
Practice Address - Country:US
Practice Address - Phone:419-378-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider