1497953384 NPI number — DAVID S FRANCOM M.D.

Table of content: DAVID S FRANCOM M.D. (NPI 1497953384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497953384 NPI number — DAVID S FRANCOM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCOM
Provider First Name:
DAVID
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1497953384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5444 S. GREEN ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84123-5632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-262-2647
Provider Business Mailing Address Fax Number:
801-262-3897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5444 S. GREEN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84123-5632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-262-8120
Provider Business Practice Location Address Fax Number:
801-262-5721
Provider Enumeration Date:
07/03/2007

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: 2085N0700X , with the licence number:  7643696-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 7643696-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0202X , with the licence number: M-11523 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1497953384 . This is a "MOLINA HEALTHCARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1497953384 . This is a "TRIWEST/TRICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1497953384 . This is a "EDUCATORS MUTUAL INS ASSN" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1497953384 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 155540 . This is a "STERLING HEALTH PLANS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1497953384 . This is a "UUHP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 10000000609001 . This is a "BCBS OF UTAH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 107085942101 . This is a "SELECTHEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 121068 . This is a "PEHP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1089853 . This is a "DESERET MUTUAL BENEFIT ADMINISTRATORS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: P00855367 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com