Provider Demographics
NPI:1881757037
Name:FRAME, FREDERICK RAY (DO)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:RAY
Last Name:FRAME
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 N 24TH STREET
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6232
Mailing Address - Country:US
Mailing Address - Phone:602-955-3700
Mailing Address - Fax:
Practice Address - Street 1:4021 N 24TH STREET
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6232
Practice Address - Country:US
Practice Address - Phone:602-955-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1091208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E77534Medicare UPIN