Provider Demographics
NPI:1750544946
Name:FRANK, JAMES BRANDON (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRANDON
Last Name:FRANK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1700 OLD LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9615
Mailing Address - Country:US
Mailing Address - Phone:270-789-6082
Mailing Address - Fax:270-789-6080
Practice Address - Street 1:1700 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9615
Practice Address - Country:US
Practice Address - Phone:270-789-6082
Practice Address - Fax:270-789-6080
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYIP1092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100083720Medicaid
KY3385764Medicare PIN