| Jacob Eldon Frazier, DMD, MS | |
| 
					110 Wakanda Dr, Lebanon, IL 62254-1393  | |
| (618) 808-0511 | |
| (618) 808-0533 | 
| Full Name | Jacob Eldon Frazier | 
|---|---|
| Gender | Male | 
| Speciality | Dentist - Endodontics | 
| Location | 110 Wakanda Dr, Lebanon, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497043178 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019028757 (Illinois) | Secondary | 
| 1223E0200X | Dentist - Endodontics | 021.002661 (Illinois) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jacob Eldon Frazier, DMD, MS 110 Wakanda Dr, Lebanon, IL 62254-1393 Ph: (618) 808-0511  | Jacob Eldon Frazier, DMD, MS 110 Wakanda Dr, Lebanon, IL 62254-1393 Ph: (618) 808-0511  | 
Meagan Elise Graul, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 229 W Saint Louis St Ste 1, Lebanon, IL 62254 Phone: 618-537-2017  | |
Dr. Joseph Alan Cioni, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 229 W Saint Louis St, Ste 1, Lebanon, IL 62254 Phone: 618-537-2017 Fax: 618-537-9510  |