Provider Demographics
NPI:1902115330
Name:FRANCISCAN MEDICAL GROUP
Entity Type:Organization
Organization Name:FRANCISCAN MEDICAL GROUP
Other - Org Name:FRANCISCAN UROLOGY - GIG HARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CMO
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-680-4009
Mailing Address - Street 1:6401 KIMBALL DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1228
Mailing Address - Country:US
Mailing Address - Phone:253-858-9192
Mailing Address - Fax:253-858-4330
Practice Address - Street 1:6401 KIMBALL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1228
Practice Address - Country:US
Practice Address - Phone:253-858-9192
Practice Address - Fax:253-858-4330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty