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General NPI Number Information
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NPI Number | 1568776193
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Entity Type | Organization
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Legal Business Name | DR. BENNETT D FRANK MD, PHD LLC
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 969 N MASON RD SUITE 155
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6338
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Country | US
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Telephone | 314-628-9990
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Fax | 314-628-9992
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Provider Business Mailing Address
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Address Line | 969 N MASON RD SUITE 155
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6338
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Country | US
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Telephone | 314-628-9990
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Fax | 314-628-9992
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENNETT DAVID FRANK
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Credential | MD
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Telephone | 314-628-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 36944
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License Number State | MO
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