Provider Demographics
NPI:1811082662
Name:RASTER, JOHN FRANKLIN (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANKLIN
Last Name:RASTER
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 1:10301 GLACIER HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8561
Mailing Address - Country:US
Mailing Address - Phone:907-790-4047
Mailing Address - Fax:907-790-4368
Practice Address - Street 1:10301 GLACIER HWY STE 100
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8561
Practice Address - Country:US
Practice Address - Phone:907-790-4047
Practice Address - Fax:907-790-4368
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3640207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD0287Medicaid
AKK0000BLBQHMedicare ID - Type Unspecified
AKMD0287Medicaid