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General NPI Number Information
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NPI Number | 1275807760
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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 | 02/29/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 314 MARTIN LUTHER KING JR WAY STE 400
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City | TACOMA
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State | WA
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Zip | 98405-4250
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Country | US
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Telephone | 253-582-5141
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Fax | 253-627-2879
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Provider Business Mailing Address
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Address Line | 314 MARTIN LUTHER KING JR WAY STE 400
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City | TACOMA
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State | WA
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Zip | 98405-4250
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Country | US
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Telephone | 253-582-5141
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Fax | 253-627-2879
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Authorized Official
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Title or Position | PRESIDENT & CMO
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Name | STEPHEN SPARE
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Credential | MD
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Telephone | 253-680-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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