Individual provider · NPI-1

Dr. Ivey Michele Frazier, DDS

Dentist · Muskogee, OK

NPI number1811797277
StatusActive
Last updated in NPPESMay 25, 2025

Details

NPI
1811797277
Entity type
Individual (NPI-1)
Name
Dr. Ivey Michele Frazier
Credential
DDS
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 15, 2025
Certification date
May 25, 2025
Last updated
May 25, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist8075OKYes
390200000X Student in an Organized Health Care Education/Training Program–TN

Practice location

2909 Azalea Park Dr
Muskogee, OK 74401-2283

Phone 615-887-9711

Mailing address

2909 Azalea Park Dr
Muskogee, OK 74401-2283

Phone 615-887-9711

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