Healthcare Provider Details

I. General information

NPI: 1326048992
Provider Name (Legal Business Name): FRANCISCO J HERRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 CANAL STREET SUITE 200
POOLER GA
31322
US

IV. Provider business mailing address

PO BOX 668
POOLER GA
31322
US

V. Phone/Fax

Practice location:
  • Phone: 912-748-4527
  • Fax: 912-748-9016
Mailing address:
  • Phone: 912-748-4527
  • Fax: 912-748-9016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME69419
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number057179
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: