Provider Demographics
NPI:1821286451
Name:WANG, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S INGLESIDE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1804
Mailing Address - Country:US
Mailing Address - Phone:251-990-1740
Mailing Address - Fax:251-990-1831
Practice Address - Street 1:150 S INGLESIDE ST STE 6
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1804
Practice Address - Country:US
Practice Address - Phone:251-990-1740
Practice Address - Fax:251-990-1831
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-05341OtherBCBS OF AL
AL118584Medicaid
AL102I116673Medicare PIN