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NPI Code Detail

MEDICARE: JOSEPH THOMAS FROST R.D.

MEDICARE: JOSEPH THOMAS FROST R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133NN1002XNutrition Education NutritionistDI00001355WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1888820OTHERAKCDR

General Provider Information

NPI Number : 1407987456
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH THOMAS FROST R.D.
Provider Business Mailing Address
First Line : 2960 TONGASS AVE
Second Line : SUITE 403
City : KETCHIKAN
State : AK
Zip : 99901-5742
Country : US
Telephone Number : 907-228-4902
Fax Number : 907-228-5256
Provider Business Practice Location Address
First Line : 2960 TONGASS AVE
Second Line : SUITE 403
City : KETCHIKAN
State : AK
Zip : 99901-5742
Country : US
Telephone Number : 907-228-4902
Fax Number : 907-228-5256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/08/2007

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Directions to “ JOSEPH THOMAS FROST R.D.” Practice Location

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