Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 036529 | GA |
NPI | 1003131244 |
---|---|
Provider Name | James Nicholas Frisk |
First Address | Athens, GA 30606-3237 |
Second Address | Athens, GA 30606-3237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2010 |
Last Update Date | 31/03/2010 |