Provider Demographics
NPI:1427625714
Name:FRANK, LANDON MITCHELL
Entity type:Individual
Prefix:MR
First Name:LANDON
Middle Name:MITCHELL
Last Name:FRANK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1373 E BOONE ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-3365
Mailing Address - Country:US
Mailing Address - Phone:918-207-0025
Mailing Address - Fax:
Practice Address - Street 1:1373 E BOONE ST STE 2300
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3365
Practice Address - Country:US
Practice Address - Phone:918-207-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK8183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program