Provider Demographics
NPI:1316993066
Name:DAVIS, FRANK MIKE (O D)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MIKE
Last Name:DAVIS
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 RIVERWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:KINGS MILLS
Mailing Address - State:OH
Mailing Address - Zip Code:45034-9766
Mailing Address - Country:US
Mailing Address - Phone:513-310-6293
Mailing Address - Fax:
Practice Address - Street 1:3918 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2322
Practice Address - Country:US
Practice Address - Phone:513-794-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3338/T402152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH203118709OtherTIN/EIN
OHT47069Medicare UPIN