Provider Demographics
NPI:1225033293
Name:FRANK, LAURENCE EDWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:EDWARD
Last Name:FRANK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-3020
Mailing Address - Country:US
Mailing Address - Phone:937-746-0586
Mailing Address - Fax:937-746-0587
Practice Address - Street 1:766 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-3020
Practice Address - Country:US
Practice Address - Phone:937-746-0586
Practice Address - Fax:937-746-0587
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003196213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2188001Medicaid
OHH067590Medicare PIN