Healthcare Provider Details

I. General information

NPI: 1881709855
Provider Name (Legal Business Name): KAY ELLEN FRANK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAY ELLEN BURDETTE MD

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 LAIDLEY ST SUITE 301
CHARLESTON WV
25301-1619
US

IV. Provider business mailing address

331 LAIDLEY ST SUITE 301
CHARLESTON WV
25301-1619
US

V. Phone/Fax

Practice location:
  • Phone: 304-346-4400
  • Fax: 304-346-0704
Mailing address:
  • Phone: 304-346-4400
  • Fax: 304-346-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35-032436
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number9281
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number35032436
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number9281
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: