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Individual

ELLIS FRAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 INDIAN RIDGE DR, PIKETON, OH 45661-9654
(740) 289-1548
(740) 289-3989
Mailing address
100 INDIAN RIDGE DR, PIKETON, OH 45661-9654
(740) 289-1548
(740) 289-3989

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35052676F
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000281343
UNISON
OH
01
000000634422
ANTHEM
05
0720769
OH
01
2534182
CIGNA
Enumeration date
10/13/2005
Last updated
11/25/2020
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