Provider Demographics
NPI:1386672715
Name:FRANK, EMILY KAUFMAN (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KAUFMAN
Last Name:FRANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1476
Mailing Address - Country:US
Mailing Address - Phone:765-485-8000
Mailing Address - Fax:765-483-7396
Practice Address - Street 1:2505 N LEBANON ST
Practice Address - Street 2:STE 220
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-8612
Practice Address - Country:US
Practice Address - Phone:765-483-7334
Practice Address - Fax:765-483-7396
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051731A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200277340Medicaid
IN220620CCCCMedicare PIN
IN200277340Medicaid