Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086X0206X | Surgical Oncologist | 37504 | IA |
Y | 2086X0206X | Surgical Oncologist | MD425405 | PA |
NPI | 1023218286 |
---|---|
Provider Name | Jan Franko |
First Address | Des Moines, IA 50305-1475 |
Second Address | Des Moines, IA 50314-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 02/05/2012 |