Provider Demographics
NPI:1891783411
Name:AGNONE, FRANK A (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:AGNONE
Suffix:
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 1:345 E VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1202
Mailing Address - Country:US
Mailing Address - Phone:602-258-5545
Mailing Address - Fax:602-258-5545
Practice Address - Street 1:345 E VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004
Practice Address - Country:US
Practice Address - Phone:602-258-5545
Practice Address - Fax:602-258-5545
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19694207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F81854Medicare UPIN
25903Medicare ID - Type Unspecified