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NPI Code Detail

MEDICARE: REGAN JOY FRAKE M.D.

MEDICARE: REGAN JOY FRAKE M.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
1207Q00000XFamily Medicine Physician85077GA

General Provider Information

NPI Number : 1851823520
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGAN JOY FRAKE M.D.
Provider Business Mailing Address
First Line : 3758 HIGHWAY 42
Second Line :
City : LOCUST GROVE
State : GA
Zip : 30248-3653
Country : US
Telephone Number : 678-561-9430
Fax Number : 770-914-1070
Provider Business Practice Location Address
First Line : 3758 HIGHWAY 42
Second Line :
City : LOCUST GROVE
State : GA
Zip : 30248-3653
Country : US
Telephone Number : 678-561-9430
Fax Number : 770-914-1070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2017
Last Update Date : 09/01/2020

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Directions to “ REGAN JOY FRAKE M.D.” Practice Location

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