Provider Demographics
NPI:1508889130
Name:STODDARD, FRANK G (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:G
Last Name:STODDARD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:830 AMHERST RD NE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8518
Mailing Address - Country:US
Mailing Address - Phone:330-833-3668
Mailing Address - Fax:330-833-2267
Practice Address - Street 1:830 AMHERST RD NE
Practice Address - Street 2:SUITE 104
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8518
Practice Address - Country:US
Practice Address - Phone:330-833-3668
Practice Address - Fax:330-833-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH3130213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2135657Medicaid
OH4073890001Medicare NSC
OHU74981Medicare UPIN
OH4223981Medicare PIN