Provider Demographics
NPI:1134121643
Name:FRANK, JOAN LESLIE (OD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:LESLIE
Last Name:FRANK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9795 CROSSPOINT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3354
Mailing Address - Country:US
Mailing Address - Phone:317-254-6480
Mailing Address - Fax:317-259-8609
Practice Address - Street 1:54 MONUMENT CIR
Practice Address - Street 2:SUITE 125
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2942
Practice Address - Country:US
Practice Address - Phone:317-631-1200
Practice Address - Fax:317-631-1600
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001977A152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000813075OtherANTHEM
INU24188Medicare UPIN
IN894060011Medicare PIN