Provider Demographics
NPI:1619980703
Name:REA, FRANCO R (MD)
Entity Type:Individual
Prefix:
First Name:FRANCO
Middle Name:R
Last Name:REA
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 1:3455 LUTHERAN PKWY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6028
Mailing Address - Country:US
Mailing Address - Phone:303-467-1400
Mailing Address - Fax:303-467-1467
Practice Address - Street 1:3455 LUTHERAN PKWY
Practice Address - Street 2:SUITE 290
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6028
Practice Address - Country:US
Practice Address - Phone:303-467-1400
Practice Address - Fax:303-467-1467
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY27240208G00000X
IN40712208G00000X
CO48896208G00000X
OH35. 054111208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64272404Medicaid
000000562595OtherANTHEM FACET
CO64272404Medicaid
IN200897280 AMedicaid
KY64272404Medicaid
KY00671001Medicare PIN
000000562595OtherANTHEM FACET