Individual
DR. LESLEY A FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 16TH ST, GREELEY, CO 80631-5114
(970) 350-2426
(970) 350-2452
Mailing address
1900 16TH ST, GREELEY, CO 80631-5114
(970) 350-2426
(970) 350-2452
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36633
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01366335
—
CO
01
—
P00944733
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
01/02/2006
Last updated
07/01/2013
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