Provider Demographics
NPI:1871976829
Name:FRAZIER, ROBERT LEE III
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:FRAZIER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5701
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32627-5701
Mailing Address - Country:US
Mailing Address - Phone:866-616-7842
Mailing Address - Fax:877-322-1872
Practice Address - Street 1:1309 NE 28TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3160
Practice Address - Country:US
Practice Address - Phone:352-538-7214
Practice Address - Fax:877-322-1872
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies