Organization
FRAGGE ALLERGY & ASTHMA CLINICS PSC
Active
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
Update your record
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