Basic Information
| Provider Information | |||||||||
| NPI: | 1306801196 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RADKEY | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 LAKE SUMTER LNDG | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321622699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526748905 | ||||||||
| FaxNumber: | 3526748901 | ||||||||
| Practice Location | |||||||||
| Address1: | 8877 SE 165TH MULBERRY LN | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321625887 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526741750 | ||||||||
| FaxNumber: | 3526748950 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2006 | ||||||||
| LastUpdateDate: | 05/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME150341 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2004032537 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | E-3412 | AR | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 148561001 | 05 | AR | MEDICAID | 206035313 | 05 | MO | MEDICAID |