Healthcare Provider Details

I. General information

NPI: 1104514751
Provider Name (Legal Business Name): FRANZ ERICH LOPEZ GONZALEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1771 COMMERCIAL ST
WARSAW MO
65355-3096
US

IV. Provider business mailing address

107 E ROGERS ST
CLINTON MO
64735-2627
US

V. Phone/Fax

Practice location:
  • Phone: 660-438-5193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026030888
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: