Provider Demographics
NPI:1548235948
Name:BLEYER, FRANK L (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:L
Last Name:BLEYER
Suffix:
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 1:1000 E CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-1513
Mailing Address - Country:US
Mailing Address - Phone:636-528-3348
Mailing Address - Fax:636-528-3313
Practice Address - Street 1:3331 W DEYOUNG ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5896
Practice Address - Country:US
Practice Address - Phone:618-998-7600
Practice Address - Fax:618-997-6680
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1F26174400000X, 207RC0000X
IL036068299174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036068299Medicaid
MO204958912Medicaid
IL036068299Medicaid
C47607Medicare UPIN