Fraizer, Donald

Fraizer, Donald is an individual health care provider with primary practice located at 1400 Sudderth Dr , Ruidoso NM 88345-6103. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Fraizer, Donald can be contacted via phone (505) 257-2368.

Contact Information

Primary practice address
1400 Sudderth Dr Ruidoso NM 88345-6103
Fax: (505) 257-2141
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 257884 New Mexico

Profile Details

NPI number 1609944651
LBN Legal business name Fraizer, Donald
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609944651 NPPES
New Mexico MEDICAID Q5515

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