Basic Information
Provider Information
NPI: 1285096453
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: KATHERINE
MiddleName: ERNST
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 90 JACKSON PIKE
Address2:  
City: GALLIPOLIS
State: OH
PostalCode: 456311562
CountryCode: US
TelephoneNumber: 7404465000
FaxNumber: 7404465982
Practice Location
Address1: 2131 E STATE ST
Address2:  
City: ATHENS
State: OH
PostalCode: 457012138
CountryCode: US
TelephoneNumber: 8554465937
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2016
LastUpdateDate: 10/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X35.133174OHN Allopathic & Osteopathic PhysiciansPediatrics 
207R00000X35.133174OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
041373705OH MEDICAID


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