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NPI Code Detail

MEDICARE: JEFFREY LEE FRAKES M.D.

MEDICARE: JEFFREY LEE FRAKES M.D.
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
1207L00000XAnesthesiology Physician34605KY
2207L00000XAnesthesiology Physician036136948IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2214881OTHERILMEDICARE GROUP PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407858806
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY LEE FRAKES M.D.
Provider Business Mailing Address
First Line : 4613 SHADOW WOOD CV
Second Line :
City : OWENSBORO
State : KY
Zip : 42303-4490
Country : US
Telephone Number : 270-685-6861
Fax Number :
Provider Business Practice Location Address
First Line : 405 W JACKSON ST
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1462
Country : US
Telephone Number : 618-549-0721
Fax Number : 618-529-0449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 06/04/2021

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