MEDICARE: FRANCISCO J HERRAN MD

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	208000000X	Pediatrics Physician	ME69419	FL
2	208000000X	Pediatrics Physician	057179	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	057179	OTHER	GA	GA LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326048992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCISCO J HERRAN MD

Provider Business Mailing Address
First Line	:	PO BOX 668
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322
Country	:	US
Telephone Number	:	912-748-4527
Fax Number	:	912-748-9016

Provider Business Practice Location Address
First Line	:	143 CANAL STREET
Second Line	:	SUITE 200
City	:	POOLER
State	:	GA
Zip	:	31322
Country	:	US
Telephone Number	:	912-748-4527
Fax Number	:	912-748-9016

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	12/13/2007

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