Provider Demographics
NPI:1558387548
Name:DEFABO, FRANCIS LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:LEONARD
Last Name:DEFABO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:911 LIGONIER STREET
Mailing Address - Street 2:STE 205
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650
Mailing Address - Country:US
Mailing Address - Phone:724-532-2322
Mailing Address - Fax:724-532-2405
Practice Address - Street 1:911 LIGONIER STREET
Practice Address - Street 2:STE 205
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650
Practice Address - Country:US
Practice Address - Phone:724-532-2322
Practice Address - Fax:724-532-2405
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047375L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014134900001Medicaid
729378UEKMedicare ID - Type Unspecified
PA0014134900001Medicaid