1700102878 NPI number — FRANCIS EDWARD JANES M.D.

Table of content: FRANCIS EDWARD JANES M.D. (NPI 1700102878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700102878 NPI number — FRANCIS EDWARD JANES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JANES
Provider First Name:
FRANCIS
Provider Middle Name:
EDWARD
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:
1700102878
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 76 BOX 6821
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO AP
Provider Business Mailing Address State Name:
AOMORI
Provider Business Mailing Address Postal Code:
96319
Provider Business Mailing Address Country Code:
JP
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BLDG 99
Provider Second Line Business Practice Location Address:
UNIT 5024
Provider Business Practice Location Address City Name:
APO AP
Provider Business Practice Location Address State Name:
AOMORI
Provider Business Practice Location Address Postal Code:
96319
Provider Business Practice Location Address Country Code:
JP
Provider Business Practice Location Address Telephone Number:
315-226-6647
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2010

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: 207Q00000X , with the licence number:  MD.204849 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2308254 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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