Basic Information
| Provider Information | |||||||||
| NPI: | 1770574022 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANTZ | ||||||||
| FirstName: | EARL | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3714 GUARDIAN AVE STE E | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285572975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522472101 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3714 GUARDIAN AVE STE E | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285572975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522472101 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2005 | ||||||||
| LastUpdateDate: | 01/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2013-01946 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | 2013-01946 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2013-01946 | 01 | NC | NORTH CAROLINA MEDICAL BOARD | OTHER |