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General NPI Number Information
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NPI Number | 1275562928
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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 | 07/02/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 2111 S 90TH ST
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City | TACOMA
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State | WA
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Zip | 98444-1822
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Country | US
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Telephone | 253-539-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 S 90TH ST
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City | TACOMA
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State | WA
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Zip | 98444-1822
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Country | US
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Telephone | 253-539-9700
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | CLIFF A ROBERTSON
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Credential | MD
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Telephone | 253-779-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00041631
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License Number State | WA
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