Provider Demographics
NPI:1710298617
Name:WD FRANKS JR., MD PLASTIC SURGERY INC
Entity Type:Organization
Organization Name:WD FRANKS JR., MD PLASTIC SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:FRANKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:515-249-8448
Mailing Address - Street 1:2600 GRAND AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5375
Mailing Address - Country:US
Mailing Address - Phone:515-421-4299
Mailing Address - Fax:515-288-2542
Practice Address - Street 1:2600 GRAND AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-5375
Practice Address - Country:US
Practice Address - Phone:515-421-4299
Practice Address - Fax:515-288-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35038208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1710298617Medicaid