Individual
JONATHAN G FRALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2730 ALASKA HIGHWAY, DELTA JUNCTION, AK 99737-0285
(907) 895-6233
(907) 895-6288
Mailing address
PO BOX 5, MILE 187 GLENN HIGHWAY, GLENNALLEN, AK 99588-0005
(907) 822-3203
(907) 822-5805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1197
AK
363A00000X
Physician Assistant
50002345
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075450
—
OH
01
—
PA25814
MEDICARE PTAN
OH
01
—
PA25815
MEDICARE PTAN
OH
Enumeration date
01/05/2006
Last updated
02/09/2015
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