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Organization

FRAGGE ALLERGY & ASTHMA CLINICS PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD GUY FRAGGE MD (PRESIDENT OF CORPORATION)
(859) 371-3797
Entity
Organization

Contact information

Practice address
2300 CHAMBER CENTER DR, SUITE 102, LAKESIDE PARK, KY 41017-1673
(859) 371-3797
(859) 291-1438
Mailing address
2300 CHAMBER CENTER DR, SUITE 102, LAKESIDE PARK, KY 41017-1673
(859) 371-3797
(859) 291-1438

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
12274
KY
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
30879
KY
207RP1001X
Pulmonary Disease Physician
12274
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
61071659400
WORKMAN'S COMPENSATION
KY
05
65903569
KY
Enumeration date
03/29/2007
Last updated
02/26/2015
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