Provider Demographics
NPI:1245251347
Name:DEBORAH LUETZOW-FRANSON M.D., S.C.
Entity type:Organization
Organization Name:DEBORAH LUETZOW-FRANSON M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUETZOW-FRANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-427-0008
Mailing Address - Street 1:7400 W RAWSON AVE
Mailing Address - Street 2:SUITE #142
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8278
Mailing Address - Country:US
Mailing Address - Phone:414-427-0008
Mailing Address - Fax:414-427-0607
Practice Address - Street 1:7400 W RAWSON AVE
Practice Address - Street 2:SUITE #142
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8278
Practice Address - Country:US
Practice Address - Phone:414-427-0008
Practice Address - Fax:414-427-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31555700Medicaid
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