Basic Information
| Provider Information | |||||||||
| NPI: | 1518464858 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANK | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | JACOB | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4965 MAHONING AVE | ||||||||
| Address2: | |||||||||
| City: | HOMEWORTH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446349612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308539909 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6001 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432131502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145520089 | ||||||||
| FaxNumber: | 6145520168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2018 | ||||||||
| LastUpdateDate: | 07/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35145866 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 35145866 | 01 | OH | MEDICAL LICENSE | OTHER |