Basic Information
| Provider Information | |||||||||
| NPI: | 1821041955 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANCO | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8901 W DODGE RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023542000 | ||||||||
| FaxNumber: | 4023548645 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 W DODGE RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023542000 | ||||||||
| FaxNumber: | 4023548645 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 21611 | NE | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 0539569 | 05 | IA | MEDICAID |