Healthcare Provider Details

I. General information

NPI: 1457588402
Provider Name (Legal Business Name): NICHOLAS J FRAME M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1684 N PROSPECT AVE
MILWAUKEE WI
53202-2408
US

IV. Provider business mailing address

1684 N PROSPECT AVE
MILWAUKEE WI
53202-2408
US

V. Phone/Fax

Practice location:
  • Phone: 414-271-2020
  • Fax: 414-272-3932
Mailing address:
  • Phone: 414-271-2020
  • Fax: 414-272-3932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number60463
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number60463
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: