Provider Demographics
NPI:1659352193
Name:FRANK B. FONDREN
Entity Type:Organization
Organization Name:FRANK B. FONDREN
Other - Org Name:FONDREN ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:B
Authorized Official - Last Name:FONDREN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:251-479-4767
Mailing Address - Street 1:PO BOX 70187
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-1187
Mailing Address - Country:US
Mailing Address - Phone:251-479-4767
Mailing Address - Fax:251-476-0116
Practice Address - Street 1:750 BISHOP LN N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-5808
Practice Address - Country:US
Practice Address - Phone:251-479-4767
Practice Address - Fax:251-476-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10207174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty