Provider Demographics
NPI:1649275058
Name:OGNIBENE, FRANK A (DPM)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:OGNIBENE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-0847
Mailing Address - Country:US
Mailing Address - Phone:901-821-0338
Mailing Address - Fax:
Practice Address - Street 1:7878 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2307
Practice Address - Country:US
Practice Address - Phone:901-757-0045
Practice Address - Fax:901-756-4413
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS80092213ES0103X
TNDPM 178213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3350968Medicaid
TN002004919OtherBLUE CROSS BLUE SHEILD TN
TNT61069Medicare UPIN
TN4342610001Medicare NSC
TN406480336BMedicare ID - Type UnspecifiedRAIL ROAD MEDICARE
TN002004919OtherBLUE CROSS BLUE SHEILD TN