Provider Demographics
NPI:1588812390
Name:FRANK, NATHAN THOMAS (OD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:THOMAS
Last Name:FRANK
Suffix:
Gender:M
Credentials:OD
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 DIMOND BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2029
Mailing Address - Country:US
Mailing Address - Phone:907-349-6932
Mailing Address - Fax:907-349-6347
Practice Address - Street 1:1000 E DIMOND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2029
Practice Address - Country:US
Practice Address - Phone:907-349-6932
Practice Address - Fax:907-349-6347
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3273ATI152W00000X
AKOPTT343152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC70790002OtherCAREFIRST
MD446507500Medicaid
MD97531901OtherCAREFIRST
223777YE4RMedicare PIN