Provider Demographics
NPI:1558367326
Name:FRANCISCO, DAN A (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:A
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DANNY
Other - Middle Name:
Other - Last Name:FRANCISCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 47821
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7821
Mailing Address - Country:US
Mailing Address - Phone:316-616-3333
Mailing Address - Fax:316-616-0974
Practice Address - Street 1:1515 S CLIFTON AVE
Practice Address - Street 2:STE 150
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2957
Practice Address - Country:US
Practice Address - Phone:316-616-3333
Practice Address - Fax:316-616-0974
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0419069207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
17D1048839OtherCLIA
KS1194721951OtherORGANIZATIONAL NPI
KS100112630AMedicaid
KS1194721951OtherORGANIZATIONAL NPI
KSB69453Medicare UPIN