Healthcare Provider Details

I. General information

NPI: 1295929875
Provider Name (Legal Business Name): EMILY JO FRANKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY JO RICHARDS MD

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 SOUTHERN BLVD STE 401
KETTERING OH
45429-1226
US

IV. Provider business mailing address

1 PRESTIGE PL SUITE 550
MIAMISBURG OH
45342-3794
US

V. Phone/Fax

Practice location:
  • Phone: 855-500-2873
  • Fax: 937-281-3913
Mailing address:
  • Phone: 937-752-2305
  • Fax: 937-522-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD0070450
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberP25670
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57-013205
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35121876
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: