Provider Demographics
NPI:1669438370
Name:DEFRANCO, PETER JAMES JR (D C)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
Last Name:DEFRANCO
Suffix:JR
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 ALLISON BON DR
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1641
Mailing Address - Country:US
Mailing Address - Phone:205-491-6881
Mailing Address - Fax:205-491-3919
Practice Address - Street 1:3166 ALLISON BON DR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1641
Practice Address - Country:US
Practice Address - Phone:205-491-6881
Practice Address - Fax:205-491-3919
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2815OtherHEALTHSPRING
AL631206410OtherTAX ID
AL4410053OtherUNITED HEALTHCARE
AL44788OtherBLUE CROSS BLUE SHIELD
ALT68393Medicare UPIN
ALK313Medicare ID - Type Unspecified