Basic Information
Provider Information
NPI: 1144284803
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIZZELL
FirstName: ERIC
MiddleName: RAYMOND
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 PAGE ROAD
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748798
CountryCode: US
TelephoneNumber: 9102955511
FaxNumber: 9102353432
Practice Location
Address1: 15 REGIONAL DRIVE
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748850
CountryCode: US
TelephoneNumber: 9102959207
FaxNumber: 9102353432
Other Information
ProviderEnumerationDate: 04/12/2006
LastUpdateDate: 01/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XMD31751DCN Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RG0100X2006-01095NCY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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