Healthcare Provider Details

I. General information

NPI: 1972732089
Provider Name (Legal Business Name): MICHAEL JOSEPH FRANCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 FOREST PARK AVE APT 410
SAINT LOUIS MO
63108-2891
US

IV. Provider business mailing address

4100 FOREST PARK AVE APT 410
SAINT LOUIS MO
63108-2891
US

V. Phone/Fax

Practice location:
  • Phone: 856-981-2362
  • Fax:
Mailing address:
  • Phone: 856-981-2362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number25MA09946200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2009015645
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: