Provider Demographics
NPI:1497878235
Name:ST FRANCIS FAMILY PRACTICE
Entity Type:Organization
Organization Name:ST FRANCIS FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-575-8047
Mailing Address - Street 1:701 CLAYTON STREET
Mailing Address - Street 2:2ND FLOOR MSB
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805
Mailing Address - Country:US
Mailing Address - Phone:302-577-8039
Mailing Address - Fax:302-421-8005
Practice Address - Street 1:701 NORTH CLAYTON STREET
Practice Address - Street 2:2ND FLOOR MSB
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-575-8039
Practice Address - Fax:302-575-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000188302Medicaid
DE0000188302Medicaid