Healthcare Provider Details
I. General information
NPI: 1811791874
Provider Name (Legal Business Name): FRANCIS RICARDO KAYANAN ESCUETA III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
306 LIBERTY VIEW LN
LYNCHBURG VA
24502-2291
US
IV. Provider business mailing address
104 TULANE ST
LYNCHBURG VA
24502-2418
US
V. Phone/Fax
- Phone: 434-592-6400
- Fax:
- Phone: 818-359-3170
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: