Provider Demographics
NPI:1982672432
Name:DEMARCO, FRANK R (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:R
Last Name:DEMARCO
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 1:1965 DELWIN ST
Mailing Address - Street 2:APT. 6
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2360
Mailing Address - Country:US
Mailing Address - Phone:918-284-8831
Mailing Address - Fax:
Practice Address - Street 1:1509 W TRUMAN RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-3436
Practice Address - Country:US
Practice Address - Phone:816-836-6901
Practice Address - Fax:816-836-4460
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14951207P00000X
KY57350207P00000X
MO110013207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1982672432OtherBCBS
OK100050480AMedicaid
OK1982672432OtherBCBS
OKOK401807Medicare PIN