Provider Demographics
NPI: | 1598835324 |
---|---|
Name: | FRAPPIER, J GREGORY (DO) |
Entity type: | Individual |
Prefix: | DR |
First Name: | J |
Middle Name: | GREGORY |
Last Name: | FRAPPIER |
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: | 3200 BURNET AVE |
Mailing Address - Street 2: | 3 SOUTH, CREDENTIALING |
Mailing Address - City: | CINCINNATI |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45229-3019 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 513-558-5281 |
Mailing Address - Fax: | 513-558-5791 |
Practice Address - Street 1: | 234 GOODMAN ST |
Practice Address - Street 2: | EMERGENCY MEDICINE DEPARTMENT |
Practice Address - City: | CINCINNATI |
Practice Address - State: | OH |
Practice Address - Zip Code: | 45219-2364 |
Practice Address - Country: | US |
Practice Address - Phone: | 513-558-5281 |
Practice Address - Fax: | 513-558-5791 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-11-09 |
Last Update Date: | 2015-01-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 34-004090 | 207P00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IN | 200803550 | Medicaid | |
OH | 0741442 | Medicaid | |
KY | 64865348 | Medicaid | |
OH | H044560 | Medicare PIN | |
OH | FA0657095 | Medicare ID - Type Unspecified |