Provider Demographics
NPI:1306815790
Name:FRANCE, DIANE P (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:P
Last Name:FRANCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80257
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-8004
Mailing Address - Country:US
Mailing Address - Phone:414-935-8000
Mailing Address - Fax:414-220-5184
Practice Address - Street 1:1218 W KILBOURN AVE STE 124
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233
Practice Address - Country:US
Practice Address - Phone:414-935-8000
Practice Address - Fax:414-220-5184
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63040-20207Q00000X
ARE-1625208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE30528Medicare UPIN
AR5K758Medicare ID - Type Unspecified