Provider Demographics
NPI:1649476698
Name:FRANK, MELISSA SUE (OD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUE
Last Name:FRANK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:SUE
Other - Last Name:HUMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:475 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7418
Mailing Address - Country:US
Mailing Address - Phone:207-786-2500
Mailing Address - Fax:207-786-2503
Practice Address - Street 1:245 CENTER ST.
Practice Address - Street 2:
Practice Address - City:AUBRUN
Practice Address - State:ME
Practice Address - Zip Code:04210
Practice Address - Country:US
Practice Address - Phone:207-786-2500
Practice Address - Fax:207-786-2503
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001920152W00000X
COOPT.0003117152W00000X
MEOPT1035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
50070851OtherCAPITAL BLUE CROSS
1973246OtherBLUE SHIELD
108939OtherGEISINGER
822571OtherFIRST PRIORITY HEALTH
822571OtherFIRST PRIORITY HEALTH