Provider Demographics
NPI:1730418732
Name:ASSOCIATED PODIATRISTS, PLLC
Entity type:Organization
Organization Name:ASSOCIATED PODIATRISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-623-6728
Mailing Address - Street 1:600 DAVISSON RUN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-9307
Mailing Address - Country:US
Mailing Address - Phone:304-623-6728
Mailing Address - Fax:304-623-2638
Practice Address - Street 1:600 DAVISSON RUN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-9307
Practice Address - Country:US
Practice Address - Phone:304-623-6728
Practice Address - Fax:304-623-2638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10395213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0100122000Medicaid
WV3810008964Medicaid
WV001975039OtherBLUE CROSS/BLUE SHIELD ROBERT DALE, DPM
WVWV10395OtherWEST VIRGINIA PODIATRY LICENSE NUMBER ROBERT DALE, DPM
WV001320830OtherBLUE CROSS/BLUE SHIELD DAVID FRANKE, DPM
WVWV00151OtherWEST VIRGINIA PODIATRY LICENSE NUMBER DAVID FRANKE, DPM
WVWV00151OtherWEST VIRGINIA PODIATRY LICENSE NUMBER DAVID FRANKE, DPM
WV3810008964Medicaid
WVFR0427711Medicare PIN