Provider Demographics
NPI:1053535278
Name:FRANCKE, CHARLES F III (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:FRANCKE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 LYNDON LAKES PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-4537
Mailing Address - Country:US
Mailing Address - Phone:502-426-3458
Mailing Address - Fax:
Practice Address - Street 1:8135 NEW LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4682
Practice Address - Country:US
Practice Address - Phone:502-423-1997
Practice Address - Fax:502-423-1935
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY233842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1455801Medicare ID - Type Unspecified
KYC76184Medicare UPIN