Healthcare Provider Details

I. General information

NPI: 1700102878
Provider Name (Legal Business Name): FRANCIS EDWARD JANES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 99 UNIT 5024
APO AP AOMORI
96319
JP

IV. Provider business mailing address

PSC 76 BOX 6821
APO AP AOMORI
96319
JP

V. Phone/Fax

Practice location:
  • Phone: 315-226-6647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.204849
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: