Provider Demographics
NPI:1013473800
Name:FRANDSEN, MCKAY (DO)
Entity type:Individual
Prefix:DR
First Name:MCKAY
Middle Name:
Last Name:FRANDSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4076 NEELY ROAD
Mailing Address - Street 2:BLDG 4076, ROOM 1B-201
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703
Mailing Address - Country:US
Mailing Address - Phone:907-361-6028
Mailing Address - Fax:907-361-4847
Practice Address - Street 1:1060 GAFFNEY RD
Practice Address - Street 2:
Practice Address - City:FT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-5002
Practice Address - Country:US
Practice Address - Phone:907-361-5644
Practice Address - Fax:907-361-4823
Is Sole Proprietor?:No
Enumeration Date:2019-02-16
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102206480208D00000X, 208D00000X
AK217300207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice