Healthcare Provider Details

I. General information

NPI: 1558367326
Provider Name (Legal Business Name): DAN A FRANCISCO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DANNY FRANCISCO

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S CLIFTON AVE STE 150
WICHITA KS
67218-2957
US

IV. Provider business mailing address

PO BOX 47821
WICHITA KS
67201-7821
US

V. Phone/Fax

Practice location:
  • Phone: 316-616-3333
  • Fax: 316-616-0974
Mailing address:
  • Phone: 316-616-3333
  • Fax: 316-616-0974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0419069
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0419069
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: