Provider Demographics
NPI:1528062130
Name:FRANK, RYAN P (DPM)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:P
Last Name:FRANK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 E R D MIZE RD
Mailing Address - Street 2:STE B
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1947
Mailing Address - Country:US
Mailing Address - Phone:816-478-3338
Mailing Address - Fax:
Practice Address - Street 1:2406 E R D MIZE RD
Practice Address - Street 2:STE B
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1947
Practice Address - Country:US
Practice Address - Phone:816-478-3338
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003016708213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist