Provider Demographics
NPI:1669658555
Name:FRANCO, MANUEL P (RETIRED, MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:P
Last Name:FRANCO
Suffix:
Gender:M
Credentials:RETIRED, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:506 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9038
Practice Address - Country:US
Practice Address - Phone:304-345-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1669658555Medicaid
WV3810024049OtherMEDICAID-GROUP
WVB441OtherMEDICARE-GROUP
WV0050310000Medicaid
WV0050310000Medicaid
WV3810024049OtherMEDICAID-GROUP
WV3810024049OtherMEDICAID-GROUP