Provider Demographics
NPI:1508943960
Name:FROST, FRANCIS H (PA-C)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:H
Last Name:FROST
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-736-5211
Practice Address - Street 1:4205 MCAULEY BLVD
Practice Address - Street 2:SUITE 375
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9302
Practice Address - Country:US
Practice Address - Phone:405-751-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1035363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100012180AMedicaid
OKP21769Medicare UPIN
OK099682098MMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER