Basic Information
| Provider Information | |||||||||
| NPI: | 1710946702 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARAOZ FRASER | ||||||||
| FirstName: | GONZALO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 245 N BINKLEY ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SOLDOTNA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996697523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077144111 | ||||||||
| FaxNumber: | 9072622821 | ||||||||
| Practice Location | |||||||||
| Address1: | 245 N BINKLEY ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SOLDOTNA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996697523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077144111 | ||||||||
| FaxNumber: | 9072622821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 02/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | AA1715 | AK | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | MD1715 | 05 | AK | MEDICAID |