Provider Demographics
NPI:1720055486
Name:FRISVOLD, JAMES M (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:FRISVOLD
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:W227N6103 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3969
Mailing Address - Country:US
Mailing Address - Phone:414-566-6400
Mailing Address - Fax:414-566-3866
Practice Address - Street 1:W227N6103 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3969
Practice Address - Country:US
Practice Address - Phone:414-566-6400
Practice Address - Fax:414-566-3866
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI22935-021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine