MEDICARE: MARK JOSEPH FRANZEN B.S., D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4024DC	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000033365	OTHER	KY	ANTHEM BC/BS PIN

General Provider Information

NPI Number	:	1083664882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK JOSEPH FRANZEN B.S., D.C.

Provider Business Mailing Address
First Line	:	7821 ALEXANDRIA PIKE
Second Line	:
City	:	ALEXANDRIA
State	:	KY
Zip	:	41001-1055
Country	:	US
Telephone Number	:	859-635-9799
Fax Number	:	859-635-9899

Provider Business Practice Location Address
First Line	:	7821 ALEXANDRIA PIKE
Second Line	:
City	:	ALEXANDRIA
State	:	KY
Zip	:	41001-1055
Country	:	US
Telephone Number	:	859-635-9799
Fax Number	:	859-635-9899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	07/08/2007

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