MEDICARE: DR. FRANCIS FALCK M.D., PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	033284	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010033284CT01	OTHER	CT	ANTHEM
2	030336	OTHER	CT	HEALTHNET
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0461506	OTHER	CT	AETNA
5	C010105	OTHER		TRICARE
6	NLS077	OTHER	CT	OXFORD
7	332840	OTHER	CT	CONNECTICARE

General Provider Information

NPI Number	:	1255335113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS FALCK M.D., PHD

Provider Business Mailing Address
First Line	:	35 WASHINGTON ST
Second Line	:
City	:	MYSTIC
State	:	CT
Zip	:	06355-2816
Country	:	US
Telephone Number	:	860-572-2020
Fax Number	:	860-572-2000

Provider Business Practice Location Address
First Line	:	35 WASHINGTON ST
Second Line	:
City	:	MYSTIC
State	:	CT
Zip	:	06355-2816
Country	:	US
Telephone Number	:	860-572-2020
Fax Number	:	860-572-2000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. FRANCIS FALCK M.D., PHD” Practice Location

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