Provider Demographics
NPI:1164718813
Name:FRANDSEN, THOMAS DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DOUGLAS
Last Name:FRANDSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 FORT MISSOULA RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7401
Mailing Address - Country:US
Mailing Address - Phone:406-493-1600
Mailing Address - Fax:406-493-6777
Practice Address - Street 1:2831 FORT MISSOULA RD STE 302
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7401
Practice Address - Country:US
Practice Address - Phone:406-493-1600
Practice Address - Fax:406-493-6777
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT33875207Q00000X
IDMR-1179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine