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Organization

FIRST COAST ENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN TEMPLE FRAKER MD (MD/OWNER)
(912) 729-2794
Entity
Organization

Contact information

Practice address
2040 DAN PROCTOR DR, SUITE 250, SAINT MARYS, GA 31558-3811
(912) 729-2794
(912) 729-4469
Mailing address
2040 DAN PROCTOR DR, SUITE 250, SAINT MARYS, GA 31558-3811
(912) 729-2794
(912) 729-4469

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
056552
GA

Other

Enumeration date
01/24/2008
Last updated
01/24/2008
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