Healthcare Provider Details

I. General information

NPI: 1629159207
Provider Name (Legal Business Name): FRANCO SICURO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10199 WOODFIELD LN STE 10
OLIVETTE MO
63132-2922
US

IV. Provider business mailing address

10199 WOODFIELD LANE, SUITE 10
OLIVETTE MO
63132-2922
US

V. Phone/Fax

Practice location:
  • Phone: 314-298-0023
  • Fax: 314-997-1111
Mailing address:
  • Phone: 314-298-0023
  • Fax: 314-298-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number112806
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: