Healthcare Provider Details
I. General information
NPI: 1154550010
Provider Name (Legal Business Name): MICHAEL FRANCAVILLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/13/2009
Last Update Date: 12/24/2022
Certification Date: 12/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 CENTER ST
MOBILE AL
36604-1541
US
IV. Provider business mailing address
PO BOX 746450
ATLANTA GA
30374-6450
US
V. Phone/Fax
- Phone: 251-471-7249
- Fax: 251-471-7008
- Phone: 251-434-3626
- Fax: 251-445-2464
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | MD455368 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | MD.43630 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: