1487631784 NPI number — DR. FRANKY E VOSS M.D.

Table of content: DR. FRANKY E VOSS M.D. (NPI 1487631784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487631784 NPI number — DR. FRANKY E VOSS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOSS
Provider First Name:
FRANKY
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487631784
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 W WHITE RIVER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNCIE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47303-4988
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-668-5621
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 N TILLOTSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNCIE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47304-3988
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-286-3900
Provider Business Practice Location Address Fax Number:
765-281-4299
Provider Enumeration Date:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  01037024 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100317600A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000083916 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 160018051 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P01168502 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 311767097 . This is a "CHAMPUS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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