Provider Demographics
NPI:1124241211
Name:FRANKE, TRIXY (MD)
Entity type:Individual
Prefix:
First Name:TRIXY
Middle Name:
Last Name:FRANKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 CEDAR ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2069
Mailing Address - Country:US
Mailing Address - Phone:574-237-7338
Mailing Address - Fax:574-237-7881
Practice Address - Street 1:837 CEDAR ST
Practice Address - Street 2:STE 100
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2069
Practice Address - Country:US
Practice Address - Phone:574-237-7338
Practice Address - Fax:574-237-7881
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11013326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200960360Medicaid
IN738460YYYYMedicare PIN