| Organization Name: | FRAGGE ALLERGY & ASTHMA CLINICS PSC |
| NPI Number: | 1275653909 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD GUY FRAGGE (PRESIDENT OF CORPORATION) |
| Mailing Address: | 2300 Chamber Center Dr Suite 102 Lakeside Park |
| State: | KY US |
| Postal Code: | 410171673 |
| Phone Number: | 8593713797 |
| Fax Number: | 8592911438 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 02/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | 12274 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |