FIRST COAST ENT NPI 1346427143

NPI Information

  • NPI: 1346427143
  • Provider Name: FIRST COAST ENT
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 2040 DAN PROCTOR DR
    SUITE 250
    SAINT MARYS, GA
    ZIP 31558
  • Phone: (912) 729-2794

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NPI Details

FIRST COAST ENT is a specialist in Saint Marys, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FIRST COAST ENT NPI is 1346427143. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2040 DAN PROCTOR DR
SUITE 250
SAINT MARYS, GA
ZIP 31558-811
Phone: (912) 729-2794
Fax: (912) 729-4469

The provider's authorized official is John Temple Fraker .
The authorized official title is Md/owner and has the following contact phone number (912) 729-2794.

The enumeration date for this NPI number is 1/24/2008 and was last updated on 1/24/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist056552GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP7383MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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