Provider Demographics
NPI:1497215065
Name:FRAKER, JOHN HUNTER JR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HUNTER
Last Name:FRAKER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:J.
Other - Middle Name:HUNTER
Other - Last Name:FRAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:110 FRANCIS STREET
Mailing Address - Street 2:SUITE GB
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-632-0760
Mailing Address - Fax:617-632-0765
Practice Address - Street 1:110 FRANCIS ST STE GB
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5563
Practice Address - Country:US
Practice Address - Phone:617-632-0760
Practice Address - Fax:617-632-0765
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3013677207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease