Basic Information
| Provider Information | |||||||||
| NPI: | 1306897285 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANK | ||||||||
| FirstName: | EDGAR | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | L-3549 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403837927 | ||||||||
| FaxNumber: | 7403837942 | ||||||||
| Practice Location | |||||||||
| Address1: | 1040 DELAWARE AVE | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433026416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403838060 | ||||||||
| FaxNumber: | 7403837974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 10/31/2014 | ||||||||
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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 | 207Y00000X | 35084082F | OH | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 35084082 | OH | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 353077 | 01 | SUBMITTER NO | OTHER | 1001299 | 01 | UHC | OTHER | 000000327410 | 01 | OH | ANTHEM | OTHER | 311098079 | 01 | CIGNA | OTHER | 311098079 | 01 | TAX ID | OTHER | 2476806 | 05 | OH | MEDICAID | 311098079 | 01 | TAX ID PHYSICIANS AND NON | OTHER | 311098079 | 01 | TAX ID E | OTHER | 5384131 | 01 | AETNA | OTHER |