Provider Demographics
NPI:1003879859
Name:CHOATE, FRANKLIN EDWARD (HSPP)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:EDWARD
Last Name:CHOATE
Suffix:
Gender:M
Credentials:HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975-0777
Mailing Address - Country:US
Mailing Address - Phone:574-223-8501
Mailing Address - Fax:574-223-5744
Practice Address - Street 1:707 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46375-0777
Practice Address - Country:US
Practice Address - Phone:219-879-4621
Practice Address - Fax:574-223-5744
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042082A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200491360AMedicaid
000000483316OtherANTHEM
236390AMedicare PIN
061702110Medicare Oscar/Certification
000000483316OtherANTHEM