1548487465 NPI number — DR. FRANCIS B FLANAGIN DDS

Table of content: DR. FRANCIS B FLANAGIN DDS (NPI 1548487465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548487465 NPI number — DR. FRANCIS B FLANAGIN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLANAGIN
Provider First Name:
FRANCIS
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLANAGIN
Provider Other First Name:
FRANCIS
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1548487465
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3640 ARLINGTON DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONWAY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-327-5099
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2425 PRINCE ST STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONWAY
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72034-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-329-2000
Provider Business Practice Location Address Fax Number:
501-329-2046
Provider Enumeration Date:
04/20/2007

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: 1223G0001X , with the licence number:  3263 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 975526 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 5T909 . This is a "FEDERAL BLUE CROSS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 710811527 . This is a "IRS TAXPAYER IDENTIFICATI" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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