Provider Demographics
NPI:1306828116
Name:FRANZE, INGRID E (MD)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:E
Last Name:FRANZE
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 309
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-0309
Mailing Address - Country:US
Mailing Address - Phone:712-732-4030
Mailing Address - Fax:
Practice Address - Street 1:1525 W 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-3027
Practice Address - Country:US
Practice Address - Phone:712-732-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA297572085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA32777OtherWELLMARK BCBS
NE42127426313Medicaid
IA0147017Medicaid
NE31817OtherBCBS OF NE
NE31817Medicare ID - Type Unspecified
NE42127426313Medicaid
IA0147017Medicaid