Healthcare Provider Details

I. General information

NPI: 1003861246
Provider Name (Legal Business Name): FRANKFORT ORTHOPEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 DIAGNOSTIC DR
FRANKFORT KY
40601-6556
US

IV. Provider business mailing address

108 DIAGNOSTIC DR
FRANKFORT KY
40601-6556
US

V. Phone/Fax

Practice location:
  • Phone: 502-875-7003
  • Fax: 502-875-7005
Mailing address:
  • Phone: 502-875-7003
  • Fax: 502-875-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number37995
License Number StateKY

VIII. Authorized Official

Name: MR. CHUCK LOCKE
Title or Position: VP
Credential:
Phone: 615-373-7604