Provider Demographics
NPI:1942296678
Name:MARX, FRANK GEOFFREY (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:GEOFFREY
Last Name:MARX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:F
Other - Middle Name:GEOFFREY
Other - Last Name:MARX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2865 DAGGETT AVE
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1106
Mailing Address - Country:US
Mailing Address - Phone:541-274-6311
Mailing Address - Fax:541-884-0730
Practice Address - Street 1:2865 DAGGETT AVE
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1106
Practice Address - Country:US
Practice Address - Phone:541-274-6311
Practice Address - Fax:541-884-0730
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR126466Medicaid
ORR720000BHHFVOtherMEDICARE - TYPE B
OR126466Medicaid