Provider Demographics
NPI:1023013950
Name:FRANKE, THOMAS L (PA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:L
Last Name:FRANKE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 SOUTH MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665
Mailing Address - Country:US
Mailing Address - Phone:608-637-4230
Mailing Address - Fax:608-637-4214
Practice Address - Street 1:407 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665
Practice Address - Country:US
Practice Address - Phone:608-637-4230
Practice Address - Fax:608-637-4214
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI260363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42912900Medicaid
WI42912900Medicaid
R97713Medicare UPIN