Provider Demographics
NPI:1366419277
Name:RICH, FRANK A (DO)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:RICH
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 1:920 TRAILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5007
Mailing Address - Country:US
Mailing Address - Phone:330-758-8331
Mailing Address - Fax:330-758-3818
Practice Address - Street 1:920 TRAILWOOD DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5007
Practice Address - Country:US
Practice Address - Phone:330-758-8331
Practice Address - Fax:330-758-3818
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002770207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0395264Medicaid
OHB96438Medicare UPIN
OHRI0464741Medicare ID - Type Unspecified