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JON DURWOOD FRAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
700 N BURKHARDT RD, EVANSVILLE, IN 47715-2740
(812) 474-1110
(812) 474-1303
Mailing address
PO BOX 2368, INDIANAPOLIS, IN 46206-2368
(812) 474-1110
(812) 474-1303

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01042819
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100387080
IN
05
64030752
KY
01
P00394815
RR MEDICARE
01
P00724152
RR MEDICARE TROC
IN
Enumeration date
07/21/2005
Last updated
06/01/2015
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