Provider Demographics
NPI:1851396345
Name:CANDAL, FRANCISCO J (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:J
Last Name:CANDAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 GAUSE BLVD. EAST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461
Mailing Address - Country:US
Mailing Address - Phone:985-718-4333
Mailing Address - Fax:985-267-0310
Practice Address - Street 1:2240 GAUSE BLVD. EAST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461
Practice Address - Country:US
Practice Address - Phone:985-718-4333
Practice Address - Fax:985-267-0310
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05598R207RP1001X
LAMD05598R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03405763Medicaid
LA1342254Medicaid
LA08007055OtherRAILROAD MEDICARE
LA0689859OtherAETNA
LA5L907Medicare PIN
LA0689859OtherAETNA
B61541Medicare UPIN