Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 29366 | KY |
N | 207ND0101X | MOHS-Micrographic Surgeon | 29366 | KY |
N | 207ND0900X | Dermatopathologist | 29366 | KY |
N | 207NS0135X | Procedural Dermatology | 29366 | KY |
NPI | 1063564011 |
---|---|
Provider Name | Dr. Christopher John Frost |
First Address | Somerset, KY 42503-3454 |
Second Address | Somerset, KY 42503-3454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 27/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000048630 | ANTHEM (01) | |
070007464 | RAILROAD MEDICARE (01) | |
64293665 | (05) | KY |
AF3048508 | DEA (01) | |
E05028 | (02) |