Individual
PHILIP J FRACICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 827-9488
Mailing address
601 E 14TH ST, PO BOX 1706, SEDALIA, MO 65301-5972
(660) 827-9488
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2008007036
MO
207RP1001X
Pulmonary Disease Physician
Primary
22761
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171843
—
AZ
Enumeration date
08/30/2006
Last updated
08/03/2022
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