Provider Demographics
NPI:1043441082
Name:FRANCISCAN MEDICAL GROUP
Entity type:Organization
Organization Name:FRANCISCAN MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-680-4009
Mailing Address - Street 1:15214 CANYON RD E
Mailing Address - Street 2:STE 205
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-7472
Mailing Address - Country:US
Mailing Address - Phone:253-539-4200
Mailing Address - Fax:
Practice Address - Street 1:15214 CANYON RD E
Practice Address - Street 2:STE 205
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-7472
Practice Address - Country:US
Practice Address - Phone:253-539-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-06
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty