=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043433477
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES FRANKS FAMILY MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1698 LINDAUER RD
-----------------------------------------------------
City | FORREST CITY
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72335-2529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-630-2500
-----------------------------------------------------
Fax | 870-630-2504
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1698 LINDAUER RD
-----------------------------------------------------
City | FORREST CITY
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72335-2529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-630-2500
-----------------------------------------------------
Fax | 870-630-2504
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS MANAGER
-----------------------------------------------------
Name | MS. CAROL D BAKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-630-2500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | E1393
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------