Provider Demographics
NPI:1912947417
Name:FRAZIER AND JARVIS PLLC
Entity Type:Organization
Organization Name:FRAZIER AND JARVIS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-589-8025
Mailing Address - Street 1:225 ABRAHAM FLEXNER WAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1846
Mailing Address - Country:US
Mailing Address - Phone:502-589-8025
Mailing Address - Fax:
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 303
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1846
Practice Address - Country:US
Practice Address - Phone:502-589-8025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
344534OtherAETNA HMO
IN200502990AMedicaid
KY2446131000OtherPASSPORT ADVANTAGE
KY50004779OtherPASSPORT
KY000000332129OtherANTHEM BCBS
KY65941676Medicaid
7822531OtherAETNA PPO
KY000000332129OtherANTHEM BCBS