Healthcare Provider Details

I. General information

NPI: 1265750053
Provider Name (Legal Business Name): JEAN-PHILIPPE LAFRANCE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5415 BOUL. DE L'ASSOMPTION SERVICE DE NEPHROLOGIE
MONTREAL QC
H1T 2M4
CA

IV. Provider business mailing address

5415 BOUL. DE L'ASSOMPTION SERVICE DE NEPHROLOGIE
MONTREAL QC
H1T 2M4
CA

V. Phone/Fax

Practice location:
  • Phone: 15142523400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number06382
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: