Provider Demographics
NPI:1184671927
Name:FRANKUM, CHARLES E JR (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:FRANKUM
Suffix:JR
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 1:1960 OGDEN ST
Mailing Address - Street 2:SUITE 530
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3666
Mailing Address - Country:US
Mailing Address - Phone:303-830-2004
Mailing Address - Fax:303-318-2604
Practice Address - Street 1:1960 OGDEN ST
Practice Address - Street 2:SUITE 530
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3666
Practice Address - Country:US
Practice Address - Phone:303-830-2004
Practice Address - Fax:303-318-2604
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0426574208600000X
CO39773208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103623OtherBCBS
KS2000085380CMedicaid
CO73187879Medicaid
KS105255Medicare PIN
H14270Medicare UPIN
KS103623OtherBCBS
COC496348Medicare PIN
KS103623Medicare PIN