MEDICARE: DR. JOHN FRANK ANZALONE DO

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	208D00000X	General Practice Physician	R7830	MO

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	:	1861481558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN FRANK ANZALONE DO

Provider Business Mailing Address
First Line	:	1055 E TERRA LN
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2750
Country	:	US
Telephone Number	:	636-272-6161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 E TERRA LN
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2750
Country	:	US
Telephone Number	:	636-272-6161
Fax Number	:	636-240-9188

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	12/23/2009

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Directions to “ DR. JOHN FRANK ANZALONE DO” Practice Location

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