Basic Information
| Provider Information | |||||||||
| NPI: | 1063677862 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANCISCO | ||||||||
| FirstName: | ORLANDO | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 W MOHAWK DR | ||||||||
| Address2: | |||||||||
| City: | TOMAHAWK | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544872274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7154537200 | ||||||||
| FaxNumber: | 7153614887 | ||||||||
| Practice Location | |||||||||
| Address1: | 3301 STANLEY ST | ||||||||
| Address2: | |||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544811323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153417332 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2008 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 15415 | WI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 31122700 | 05 | WI | MEDICAID |