Provider Demographics
NPI:1659479954
Name:FRANK, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2648
Mailing Address - Country:US
Mailing Address - Phone:785-331-2000
Mailing Address - Fax:785-331-2001
Practice Address - Street 1:810 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2648
Practice Address - Country:US
Practice Address - Phone:785-331-2000
Practice Address - Fax:785-331-2001
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-233512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSE98581Medicare UPIN
KS060642Medicare ID - Type Unspecified