Provider Demographics
NPI:1710946702
Name:ARAOZ FRASER, GONZALO (MD)
Entity Type:Individual
Prefix:DR
First Name:GONZALO
Middle Name:
Last Name:ARAOZ FRASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 N BINKLEY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7523
Mailing Address - Country:US
Mailing Address - Phone:907-714-4111
Mailing Address - Fax:907-262-2821
Practice Address - Street 1:245 N BINKLEY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7523
Practice Address - Country:US
Practice Address - Phone:907-714-4111
Practice Address - Fax:907-262-2821
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA1715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1715Medicaid
AKMD1715Medicaid
AK0000BHXBKMedicare PIN
AK0000BHXBKMedicare ID - Type Unspecified