Provider Demographics
NPI:1114012978
Name:LOVELL, FRANK R (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:R
Last Name:LOVELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49429-0289
Mailing Address - Country:US
Mailing Address - Phone:616-457-9000
Mailing Address - Fax:616-457-3801
Practice Address - Street 1:200 MICHIGAN ST NE
Practice Address - Street 2:STE 300
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2524
Practice Address - Country:US
Practice Address - Phone:616-391-5700
Practice Address - Fax:616-391-8612
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI025832208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3472954Medicaid
MIA78076Medicare UPIN