=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962461426
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANK L FERRIER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2006
-----------------------------------------------------
Last Update Date | 08/05/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1100 JOHNSON FERRY STE 235
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30342
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-705-9099
-----------------------------------------------------
Fax | 404-705-9094
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1901 BUTTERFIELD RD STE 220
-----------------------------------------------------
City | DOWNERS GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60515-7915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-725-2768
-----------------------------------------------------
Fax | 630-725-2783
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 011644
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 202K00000X
-----------------------------------------------------
Taxonomy Name | Phlebology Physician
-----------------------------------------------------
License Number | 011644
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------