Provider Demographics
NPI:1558460469
Name:FRAKES, REBECCA L (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:L
Last Name:FRAKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 HARRISON AVE
Mailing Address - Street 2:UNIT N
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2815
Mailing Address - Country:US
Mailing Address - Phone:513-981-4242
Mailing Address - Fax:513-347-5050
Practice Address - Street 1:6507 HARRISON AVE
Practice Address - Street 2:UNIT N
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2815
Practice Address - Country:US
Practice Address - Phone:513-981-4242
Practice Address - Fax:513-347-5050
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056997207R00000X
OH35055269207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE66090Medicare UPIN
TN3088262Medicare ID - Type Unspecified