Provider Demographics
NPI:1417952946
Name:FRANCO, REY A (MD)
Entity Type:Individual
Prefix:
First Name:REY
Middle Name:A
Last Name:FRANCO
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:PO BOX 940
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:MI
Mailing Address - Zip Code:48658-0940
Mailing Address - Country:US
Mailing Address - Phone:989-846-4535
Mailing Address - Fax:989-846-6580
Practice Address - Street 1:805 WEST CEDAR STREET
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:MI
Practice Address - Zip Code:48658-0940
Practice Address - Country:US
Practice Address - Phone:989-846-4535
Practice Address - Fax:989-846-6580
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRF037610174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101442947Medicaid
MI101442947Medicaid
MI0060003Medicare ID - Type Unspecified