Healthcare Provider Details

I. General information

NPI: 1740278696
Provider Name (Legal Business Name): EDMUND A FRANKEN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-3391
  • Fax: 319-356-2220
Mailing address:
  • Phone: 319-356-3391
  • Fax: 319-356-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number21803
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number21803
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: