Provider Demographics
NPI:1407811532
Name:FRANZON, OLOF BERNHARD (MD)
Entity Type:Individual
Prefix:
First Name:OLOF
Middle Name:BERNHARD
Last Name:FRANZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 CORNELIA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2779
Mailing Address - Country:US
Mailing Address - Phone:518-562-7777
Mailing Address - Fax:518-562-7707
Practice Address - Street 1:206 CORNELIA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2779
Practice Address - Country:US
Practice Address - Phone:518-562-7777
Practice Address - Fax:518-562-7707
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191267207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY191267OtherNYS LICENSE
NY01374616Medicaid
NY191267OtherNYS LICENSE
BB9515Medicare ID - Type Unspecified