Provider Demographics
NPI:1598864399
Name:MCCANN, FRANK J (PAC)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:MCCANN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1821 SOUTH AVE W STE 402
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6518
Practice Address - Country:US
Practice Address - Phone:406-543-8512
Practice Address - Fax:406-541-8513
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT518363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011001259Medicare PIN
MTQ73697Medicare UPIN
MT011001028Medicare PIN