Provider Demographics
NPI:1104951722
Name:FRANK C. MUNNS O.D. L.T.D.
Entity type:Organization
Organization Name:FRANK C. MUNNS O.D. L.T.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:MUNNS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:218-727-3835
Mailing Address - Street 1:6632 BERGSTROM RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-9236
Mailing Address - Country:US
Mailing Address - Phone:218-727-3835
Mailing Address - Fax:
Practice Address - Street 1:1600 MILLER TRUNK HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5640
Practice Address - Country:US
Practice Address - Phone:218-725-0204
Practice Address - Fax:218-722-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLD1918000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2228846OtherMEDICA PROVIDER ID
MN26781MUOtherBCBS PROVIDER ID
MNU49066Medicare UPIN