First Coast ENT

Primary specialty

SpecialistTaxonomy code 174400000X

License

056552 Issued in GA

Legal business name

FIRST COAST ENT

Practice address

2040 Dan Proctor Dr
Suite 250
Saint Marys, GA 31558-3811

Phone

(912) 729-2794

Fax

(912) 729-4469

NPI assigned

Jan 24, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Temple Fraker, MDNPI 1205822384

Title

MD/Owner

Phone

(912) 729-2794

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Temple Fraker, M.D.

  • Otolaryngology Physician
  • Lutz, FL
  • NPI 1205822384
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1346427143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DR",
            "address_2": "SUITE 250",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583811",
            "telephone_number": "912-729-2794",
            "fax_number": "912-729-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DR",
            "address_2": "SUITE 250",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583811",
            "telephone_number": "912-729-2794",
            "fax_number": "912-729-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST ENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "FRAKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TEMPLE",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "912-729-2794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "056552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelbie Yvonne Farmer
• Adam Fazilat, CHPA
• Shanell Feldergoodman
• Jennifer Michelle Fine, BS, MOT R//L
• First Coast Emergency Services
• Madison Flagg
• Shawn M Flores
• Florida Medical Geriatric Group
• Aleta Fox, L.C.S.W.
• Frank J. D'Anna

• Specialist in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.