Provider Demographics
NPI:1790873875
Name:FRANCE, PAUL G (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:FRANCE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6680 DIVISION AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49548-7834
Mailing Address - Country:US
Mailing Address - Phone:616-455-2525
Mailing Address - Fax:616-455-9135
Practice Address - Street 1:6680 DIVISION AVE S
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49548-7834
Practice Address - Country:US
Practice Address - Phone:616-455-2525
Practice Address - Fax:616-455-9135
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002853152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOD16594OtherBCBS
MI2589030Medicaid
MI2589030Medicaid
MIOD16594OtherBCBS