Provider Demographics
NPI:1699740159
Name:MARINO, FRANK S (DO)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:S
Last Name:MARINO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:814 PIERCE STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1058
Mailing Address - Country:US
Mailing Address - Phone:712-226-2600
Mailing Address - Fax:712-226-2605
Practice Address - Street 1:2600 OUTER DRIVE N
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104
Practice Address - Country:US
Practice Address - Phone:712-233-9330
Practice Address - Fax:712-239-8201
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA02730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE75305796314Medicaid
SD7771652Medicaid
IA6073478Medicaid
IAF32588Medicare UPIN
SD7771652Medicaid
NE75305796314Medicaid