MEDICARE: DAVID THOMAS DEFRANCE M.D.

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	207Q00000X	Family Medicine Physician	35052286	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699723759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID THOMAS DEFRANCE M.D.

Provider Business Mailing Address
First Line	:	2265 HAYES AVE
Second Line	:
City	:	FREMONT
State	:	OH
Zip	:	43420-2632
Country	:	US
Telephone Number	:	419-332-2616
Fax Number	:	419-332-2553

Provider Business Practice Location Address
First Line	:	2265 HAYES AVE
Second Line	:
City	:	FREMONT
State	:	OH
Zip	:	43420-2632
Country	:	US
Telephone Number	:	419-332-2616
Fax Number	:	419-332-2553

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	03/07/2023

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