Individual
MARK D FRAZEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
7120 CLEARVISTA DR, SUITE 2100, INDIANAPOLIS, IN 46256-1621
(317) 621-2740
(317) 621-5658
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001009A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01191737
RR MEDICARE PTAN
IN
Enumeration date
07/11/2008
Last updated
11/26/2014
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