Individual
SAMANTHA JO FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
515 MAIN ST, MADISON, WV 25130-1417
(304) 369-0393
(304) 369-0371
Mailing address
515 MAIN ST, MADISON, WV 25130-1417
(304) 369-0393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3612
WV
207Q00000X
Family Medicine Physician
ED0687
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2017
Last updated
08/24/2022
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