Provider Demographics
NPI:1750446969
Name:FRANTZ, ROBERT CLARK (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLARK
Last Name:FRANTZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 934915
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-4915
Mailing Address - Country:US
Mailing Address - Phone:404-501-7969
Mailing Address - Fax:404-501-3874
Practice Address - Street 1:4120 FIVE FORKS TRICKUM RD SW
Practice Address - Street 2:STE 105
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3133
Practice Address - Country:US
Practice Address - Phone:770-921-6900
Practice Address - Fax:770-921-6313
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2014-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA045790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH42585Medicare UPIN
GA00827241AMedicaid