MEDICARE: DR. MCKAY FRANDSEN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	0102206480	VA
2	207N00000X	Dermatology Physician	217300	AK

General Provider Information

NPI Number	:	1013473800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MCKAY FRANDSEN DO

Provider Business Mailing Address
First Line	:	4076 NEELY ROAD
Second Line	:	BLDG 4076, ROOM 1B-201
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-361-6028
Fax Number	:	907-361-4847

Provider Business Practice Location Address
First Line	:	1060 GAFFNEY RD
Second Line	:
City	:	FT WAINWRIGHT
State	:	AK
Zip	:	99703-5002
Country	:	US
Telephone Number	:	907-361-5644
Fax Number	:	907-361-4823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2019
Last Update Date	:	08/06/2025

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