Provider Demographics
NPI:1841392776
Name:CHUCK, FRANK JOHN JR (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOHN
Last Name:CHUCK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 TROTWOOD AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401
Mailing Address - Country:US
Mailing Address - Phone:931-490-4546
Mailing Address - Fax:931-490-4367
Practice Address - Street 1:1121 TROTWOOD AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:931-490-4546
Practice Address - Fax:931-490-4367
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD27161207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3094245Medicare ID - Type Unspecified
F80957Medicare UPIN