Provider Demographics
NPI:1952355042
Name:CONNALLY-FRANK, KAREN (DO)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CONNALLY-FRANK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:CONNALLY-FRANK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 746093
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6093
Mailing Address - Country:US
Mailing Address - Phone:773-352-1517
Mailing Address - Fax:312-929-0973
Practice Address - Street 1:10705 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-4061
Practice Address - Country:US
Practice Address - Phone:623-259-6749
Practice Address - Fax:602-930-4975
Is Sole Proprietor?:No
Enumeration Date:2006-05-21
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ763575Medicaid
AZZ78075Medicare PIN
AZ110187644Medicare PIN
AZG94250Medicare UPIN
AZZ27470Medicare PIN