| Doctor Name: | MR. FRED JAY FRAZIER |
| NPI Number: | 1043620461 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN,PMHNP-BC |
| License Number: | APRN79419-PMHNP-BC |
| Business Practice Address: | 3 Hospital Plz Clarksburg, WV - 263019316 |
| Business Phone Number: | 3049693100 |
| Business Fax Number: | |
| Mailing Address: | 224 Thompson Dairy Rd, FARMINGTON |
| State: | WV |
| Postal Code: | 265719000 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2014 |
| NPI Last Update Date: | 05/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | APRN79419-PMHNP-BC |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |