Provider Demographics
NPI:1871601427
Name:DEFRANCISCO, ROBERT ANTHONY (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:DEFRANCISCO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36427-0648
Mailing Address - Country:US
Mailing Address - Phone:251-809-3290
Mailing Address - Fax:251-809-3292
Practice Address - Street 1:1121 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1500
Practice Address - Country:US
Practice Address - Phone:251-809-3290
Practice Address - Fax:251-809-3292
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL202103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR35694Medicare UPIN