Basic Information
| Provider Information | |||||||||
| NPI: | 1801078373 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRANKFORT FAMILY MEDICINE PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 593 EAST MAIN STREET | ||||||||
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| City: | FRANKFORT | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022230308 | ||||||||
| FaxNumber: | 5022275764 | ||||||||
| Practice Location | |||||||||
| Address1: | 593 EAST MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022230308 | ||||||||
| FaxNumber: | 5022275764 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2007 | ||||||||
| LastUpdateDate: | 11/27/2007 | ||||||||
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| AuthorizedOfficialLastName: | LEWIS-BASS | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5022230308 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.