Provider Demographics
NPI:1083664882
Name:FRANZEN, MARK JOSEPH (BS, DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:JOSEPH
Last Name:FRANZEN
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-1055
Mailing Address - Country:US
Mailing Address - Phone:859-635-9799
Mailing Address - Fax:859-635-9899
Practice Address - Street 1:7821 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1055
Practice Address - Country:US
Practice Address - Phone:859-635-9799
Practice Address - Fax:859-635-9899
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4024DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000033365OtherANTHEM BC/BS PIN
KY000000033365OtherANTHEM BC/BS PIN
KYU05926Medicare UPIN