Provider Demographics
NPI:1790777811
Name:SECK, FRANK JOSEPH (DO)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JOSEPH
Last Name:SECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:786 W PIONEER BLVD STE A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-8862
Practice Address - Country:US
Practice Address - Phone:702-345-5000
Practice Address - Fax:702-345-2000
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 12676207QH0002X
MI5101009758207Q00000X
NVDO2574207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080B610190OtherBLUE CROSS
NVDO2574OtherSTATE LICENSE
MI5571250OtherAETNA
NV1790777811Medicaid
MI1998574Medicaid
MI010055913OtherRAILROAD MEDICARE