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General NPI Number Information
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NPI Number | 1043544224
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Entity Type | Organization
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Legal Business Name | FRANCISCAN MEDICAL GROUP
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 1624 S I ST #204
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City | TACOMA
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State | WA
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Zip | 98405-5016
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Country | US
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Telephone | 253-272-8441
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Fax | 253-272-8096
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Provider Business Mailing Address
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Address Line | 1624 S I ST #204
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City | TACOMA
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State | WA
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Zip | 98405-5016
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Country | US
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Telephone | 253-272-8441
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Fax | 253-272-8096
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DEAN A FIELD
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Credential | MD
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Telephone | 253-680-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | WA
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