1609873785 NPI number — PATRICK M FRANCKE MD

Table of content: PATRICK M FRANCKE MD (NPI 1609873785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609873785 NPI number — PATRICK M FRANCKE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCKE
Provider First Name:
PATRICK
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1609873785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4708 OLEANDER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MYRTLE BEACH
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29577-5742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-449-9415
Provider Business Mailing Address Fax Number:
843-449-2160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4708 OLEANDER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MYRTLE BEACH
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29577-5742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-449-9415
Provider Business Practice Location Address Fax Number:
843-449-2160
Provider Enumeration Date:
07/05/2005

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: 2085R0001X , with the licence number:  ME0077442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: TL33194 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 46780 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5338095 . This is a "AETNA" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 7200427 . This is a "GHI PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8792 . This is a "TOTAL HLTH CH. PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00900588 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1542J . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 80023849 . This is a "SELECT HEALTH" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 256933700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 331947 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000388210 . This is a "UNITED HEALTHCARE COMMUNITY PLAN (UNISON)" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 239338 . This is a "AMERIGROUP PROVIDER NUM." identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 8889 . This is a "DIMENSION HLTH. PROV. #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 905189 . This is a "FIRST HEALTH PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4608762-005 . This is a "CIGNA PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5912832 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 167847 . This is a "WELLCARE PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5338095 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 32252 . This is a "NHP THRU PMG PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 259924 . This is a "AVMED PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 774386 . This is a "WELLCARE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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