Provider Demographics
NPI:1588627939
Name:TEED, FRANK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:TEED
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 1:2914 CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-4227
Mailing Address - Country:US
Mailing Address - Phone:870-246-7000
Mailing Address - Fax:870-246-2159
Practice Address - Street 1:2914 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4227
Practice Address - Country:US
Practice Address - Phone:870-246-7000
Practice Address - Fax:870-246-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-6475174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127891002Medicaid
AR0886410001Medicare NSC
ARDF6349Medicare PIN
ARB90613Medicare UPIN