Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5383 | NC |
N | 111N00000X | Chiropractor | CH12646 | FL |
N | 111NI0013X | Independent Medical Examiner | CH12646 | FL |
NPI | 1275150484 |
---|---|
Provider Name | Dr. Richard S Frost |
First Address | Denver, NC 28037-5038 |
Second Address | Denver, NC 28037-5038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2020 |
Last Update Date | 19/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5383 | CHIROPRACTIC PHYSICIAN (01) | NC |
CH12646 | MEDICAL LICENSE (01) | FL |