Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | R9D29 | MO |
Y | 207Q00000X | Family Doctor | R9D29 | MO |
NPI | 1205851128 |
---|---|
Provider Name | Mr. Scott Alan Franksen |
First Address | Saint Joseph, MO 64506-4954 |
Second Address | Saint Joseph, MO 64506-4954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 06/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
242045144 | (05) | MO |
B91307 | (02) |