Provider Demographics
NPI:1740278217
Name:PODBIELSKI, FRANCIS J (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:J
Last Name:PODBIELSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-629-3500
Mailing Address - Fax:573-406-5888
Practice Address - Street 1:6500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6890
Practice Address - Country:US
Practice Address - Phone:573-629-3400
Practice Address - Fax:573-629-3988
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085089208G00000X
MA210446208G00000X
IN01047323A208G00000X
MO2020038955208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02193786Medicaid
MA0144380Medicaid
IL036085089Medicaid
P00340847Medicare PIN
ILF400138773Medicare PIN
MAUX6509Medicare PIN
ILF400138772Medicare PIN
MA0144380Medicaid
MAA32835Medicare PIN