Basic Information
Provider Information | |||||||||
NPI: | 1386739449 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FRANKS | ||||||||
FirstName: | RALPH | ||||||||
MiddleName: | ROBERT | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: | JR. | ||||||||
Credential: | DO | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 833 CHESTNUT ST STE 520 | ||||||||
Address2: |   | ||||||||
City: | PHILADELPHIA | ||||||||
State: | PA | ||||||||
PostalCode: | 191074430 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8003219999 | ||||||||
FaxNumber: | 2673393761 | ||||||||
Practice Location | |||||||||
Address1: | 999 ROUTE 73 N STE 401 | ||||||||
Address2: |   | ||||||||
City: | MARLTON | ||||||||
State: | NJ | ||||||||
PostalCode: | 080531227 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2673393558 | ||||||||
FaxNumber: | 2673393763 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/04/2006 | ||||||||
LastUpdateDate: | 02/18/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/18/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | OS012860 | PA | N |   | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207QS0010X | 25MB07128700 | NJ | Y |   | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
ID Information
ID | Type | State | Issuer | Description | 2316478000 | 01 | PA | KEYSTONE/ IBC | OTHER | 3K4988 | 01 | NJ | HEALTHNET | OTHER | 40737 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 60008139 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 1673124 | 01 | NJ | AMERIHEALTH PPO/ IBC/ PA BS | OTHER | 3566232 & 3566238 | 01 | NJ | AETNA | OTHER | 5633670 | 01 | NJ | HEALTHNET | OTHER | 0038270 | 05 | NJ |   | MEDICAID | 2347921000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 2490721 | 01 | NJ | UNITED HEALTHCARE | OTHER | 010006325 | 01 | NJ | AMERICHOICE | OTHER | P3344520 | 01 | NJ | OXFORD | OTHER | 5633670 | 01 | NJ | CIGNA | OTHER |