Provider Demographics
NPI:1730142589
Name:BUGG, FRANLYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANLYNN
Middle Name:
Last Name:BUGG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 E 56TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2903
Mailing Address - Country:US
Mailing Address - Phone:563-383-2667
Mailing Address - Fax:563-383-2672
Practice Address - Street 1:4700 E 56TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2903
Practice Address - Country:US
Practice Address - Phone:563-421-0480
Practice Address - Fax:563-421-0489
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
IA00793170100000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI16273Medicare ID - Type Unspecified