Individual provider Active NPI

Eric Daniel Frazier, PHARM D

  • Pharmacist
  • Paducah, KY
National Provider Identifier
1336743186
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
015035 Issued in KY
Practice address
3275 Irvin Cobb Dr
Paducah, KY 42003-0338
Phone
(270) 443-4885
Fax
(270) 443-0389
NPI assigned
Nov 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 015035 KY Primary

Addresses

Primary practice location

3275 Irvin Cobb Dr
Paducah, KY 42003-0338

Mailing address

3275 Irvin Cobb Dr
Paducah, KY 42003-0338
Phone (270) 443-4885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
015035KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky CVS Pharmacy, L.L.C. PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1336743186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 IRVIN COBB DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420030338",
            "telephone_number": "270-443-4885",
            "fax_number": "270-443-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 IRVIN COBB DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420030338",
            "telephone_number": "270-443-4885",
            "fax_number": "270-443-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "ERIC",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "015035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.