MEDICARE: CARL THOMAS FRANK 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
1	174400000X	Specialist	11319	NE
2	174400000X	Specialist	23948	IA

Other Identifiers

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

General Provider Information

NPI Number	:	1669471173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL THOMAS FRANK M.D.

Provider Business Mailing Address
First Line	:	16909 LAKESIDE HILLS CT
Second Line	:	LAKESIDE PROF CRT N STE 200
City	:	OMAHA
State	:	NE
Zip	:	68130-2318
Country	:	US
Telephone Number	:	402-571-5323
Fax Number	:	402-571-2495

Provider Business Practice Location Address
First Line	:	16909 LAKESIDE HILLS CT
Second Line	:	LAKESIDE PROF CRT N STE 200
City	:	OMAHA
State	:	NE
Zip	:	68130-2318
Country	:	US
Telephone Number	:	402-571-5323
Fax Number	:	402-571-2495

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/08/2007

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Directions to “ CARL THOMAS FRANK M.D.” Practice Location

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