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Individual

CHARLES H. FRAGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4250 BETHEL RD, OLIVE BRANCH, MS 38654-8737
(901) 516-1290
(901) 516-1220
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25053
MS
207R00000X
Internal Medicine Physician
55513
TN
208M00000X
Hospitalist Physician
Primary
25053
MS
208M00000X
Hospitalist Physician
MD55513
TN

Other

Enumeration date
04/12/2013
Last updated
05/30/2024
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