Provider Demographics
NPI:1548623846
Name:FRANK HARRELL MD PA
Entity type:Organization
Organization Name:FRANK HARRELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-203-4170
Mailing Address - Street 1:312 S 4TH ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3021
Mailing Address - Country:US
Mailing Address - Phone:502-203-4170
Mailing Address - Fax:502-242-3086
Practice Address - Street 1:312 S 4TH ST
Practice Address - Street 2:SUITE 700
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3021
Practice Address - Country:US
Practice Address - Phone:502-203-4170
Practice Address - Fax:502-242-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18577261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service