Provider Demographics
NPI:1295735199
Name:PATRICK, FRANK T (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:T
Last Name:PATRICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 771244
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63177-2244
Mailing Address - Country:US
Mailing Address - Phone:314-525-4100
Mailing Address - Fax:314-525-4891
Practice Address - Street 1:10004 KENNERLY RD
Practice Address - Street 2:STE 230A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2141
Practice Address - Country:US
Practice Address - Phone:314-525-4100
Practice Address - Fax:314-525-4891
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2008-01-10
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Provider Licenses
StateLicense IDTaxonomies
MO103519207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF85362Medicare UPIN