Provider Demographics
NPI:1508822438
Name:OKTAVEC, FRANK J (PA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:OKTAVEC
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:294 HIGHWAY 515 W UNIT L
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-3662
Mailing Address - Country:US
Mailing Address - Phone:706-745-8790
Mailing Address - Fax:706-745-8842
Practice Address - Street 1:231 HIGHWAY 515
Practice Address - Street 2:STE 5
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512
Practice Address - Country:US
Practice Address - Phone:706-745-8790
Practice Address - Fax:706-745-8842
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2010-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA000058363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA100001784AMedicaid
GA97BBGNZMedicare ID - Type Unspecified
GA100001784AMedicaid