Provider Demographics
NPI:1437469368
Name:FRANCISCAN MEDICAL GROUP
Entity Type:Organization
Organization Name:FRANCISCAN MEDICAL GROUP
Other - Org Name:FRANCISCAN UROLOGY ASSOCIATES-GIG HARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-858-9192
Mailing Address - Street 1:PO BOX 31001-1518
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-1518
Mailing Address - Country:US
Mailing Address - Phone:253-552-4100
Mailing Address - Fax:253-552-4175
Practice Address - Street 1:6401 KIMBALL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1228
Practice Address - Country:US
Practice Address - Phone:253-858-9192
Practice Address - Fax:253-858-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty