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Individual

BENJAMIN FRAZIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4301 W MARKHAM ST # 634, LITTLE ROCK, AR 72205-7101
(501) 686-7592
Mailing address
4600 CRESTWOOD DR, LITTLE ROCK, AR 72207-5434

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127187081
AR
Enumeration date
04/11/2022
Last updated
04/11/2022
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