Basic Information
| Provider Information | |||||||||
| NPI: | 1740223726 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANCIS | ||||||||
| FirstName: | LARRY | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 277 ROY CAMPBELL DR | ||||||||
| Address2: | |||||||||
| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417019485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064351708 | ||||||||
| FaxNumber: | 6064352445 | ||||||||
| Practice Location | |||||||||
| Address1: | 277 ROY CAMPBELL DR | ||||||||
| Address2: | |||||||||
| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417019485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064351708 | ||||||||
| FaxNumber: | 6064352445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 10/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35737 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | 35737 | KY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 64022809 | 05 | KY | MEDICAID | 000000201942 | 01 | KY | BLUECROSS PIN | OTHER | 000000388437 | 01 | KY | BLUECROSS PIN | OTHER |