Provider Demographics
NPI: | 1841745171 |
---|---|
Name: | FRANK ARCHER, MD, LLC |
Entity Type: | Organization |
Organization Name: | FRANK ARCHER, MD, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SOLE MEMBER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | FRANK |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ARCHER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 801-429-8000 |
Mailing Address - Street 1: | 24 N 100 E |
Mailing Address - Street 2: | |
Mailing Address - City: | SPANISH FORK |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84660-1802 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 801-429-8000 |
Mailing Address - Fax: | 385-888-9171 |
Practice Address - Street 1: | 24 N 100 E |
Practice Address - Street 2: | |
Practice Address - City: | SPANISH FORK |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84660-1802 |
Practice Address - Country: | US |
Practice Address - Phone: | 801-429-8000 |
Practice Address - Fax: | 385-888-9171 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-08-16 |
Last Update Date: | 2016-08-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
UT | 6701075-1205 | 207Q00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty |