Provider Demographics
NPI:1689036329
Name:FRAZIER, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAINT VINCENT CIR STE 160
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5406
Mailing Address - Country:US
Mailing Address - Phone:501-661-0037
Mailing Address - Fax:501-661-0038
Practice Address - Street 1:1 SAINT VINCENT CIR STE 160
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5406
Practice Address - Country:US
Practice Address - Phone:501-661-0037
Practice Address - Fax:501-661-0038
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE12577207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease