Provider Demographics
NPI:1306897285
Name:FRANK, EDGAR (MD)
Entity type:Individual
Prefix:
First Name:EDGAR
Middle Name:
Last Name:FRANK
Suffix:
Gender:M
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:L-3549
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-0001
Mailing Address - Country:US
Mailing Address - Phone:740-383-7927
Mailing Address - Fax:740-383-7942
Practice Address - Street 1:1040 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6416
Practice Address - Country:US
Practice Address - Phone:740-383-8060
Practice Address - Fax:740-383-7974
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084082F207Y00000X
OH35084082207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
353077OtherSUBMITTER NO
1001299OtherUHC
OH000000327410OtherANTHEM
311098079OtherCIGNA
311098079OtherTAX ID
OH2476806Medicaid
311098079OtherTAX ID PHYSICIANS AND NON
311098079OtherTAX ID E
5384131OtherAETNA
OH000000327410OtherANTHEM
P00111896Medicare ID - Type UnspecifiedTRAVELERS
1001299OtherUHC
311098079OtherCIGNA
OHH124580Medicare PIN