Provider Demographics
NPI:1205000650
Name:FRANS S. HANDOYO, M.D., INC.
Entity Type:Organization
Organization Name:FRANS S. HANDOYO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-752-7370
Mailing Address - Street 1:3535 S JEFFERSON AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3935
Mailing Address - Country:US
Mailing Address - Phone:314-752-7370
Mailing Address - Fax:314-752-7377
Practice Address - Street 1:3535 S JEFFERSON AVE STE 310
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3935
Practice Address - Country:US
Practice Address - Phone:314-752-7370
Practice Address - Fax:314-752-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9065207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty