Provider Demographics
NPI:1255335113
Name:FALCK, FRANCIS (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:
Last Name:FALCK
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2816
Mailing Address - Country:US
Mailing Address - Phone:860-572-2020
Mailing Address - Fax:860-572-2000
Practice Address - Street 1:35 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2816
Practice Address - Country:US
Practice Address - Phone:860-572-2020
Practice Address - Fax:860-572-2000
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033284207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010033284CT01OtherANTHEM
CT030336OtherHEALTHNET
CT001332840Medicaid
CT0461506OtherAETNA
C010105OtherTRICARE
CTNLS077OtherOXFORD
CT332840OtherCONNECTICARE
CT010033284CT01OtherANTHEM
CTNLS077OtherOXFORD