Frazier O'Bannon, Larita L

Frazier O'Bannon, Larita L is an individual health care provider with primary practice located at 4623 Wesley Ave Ste P, Cincinnati OH 45212-2246. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Frazier O'Bannon, Larita L can be contacted via phone (513) 841-0777.

Contact Information

Primary practice address
4623 Wesley Ave Ste P Cincinnati OH 45212-2246
Phone: (513) 841-0777
Fax: (513) 841-0877
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 35-063095 Ohio
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 35-063095 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.063095 Ohio

Profile Details

NPI number 1588694541
LBN Legal business name Frazier O'Bannon, Larita L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated May 20th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588694541 NPPES
Ohio MEDICAID 0904703

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