Healthcare Provider Details

I. General information

NPI: 1346200078
Provider Name (Legal Business Name): FRANCIS X MCGOWAN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH STREET AND CIVIC CENTER BOULEVARD SUITE 9329
PHILADELPHIA PA
19104-4399
US

IV. Provider business mailing address

100 E PENN SQ THE WANAMAKER BUILDING, 9TH FLOOR
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1858
  • Fax: 215-590-1415
Mailing address:
  • Phone: 267-425-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number80621
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMD041477L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: