Provider Demographics
NPI:1366608770
Name:FRANCIS, SERENE ANNIE (M D)
Entity type:Individual
Prefix:DR
First Name:SERENE
Middle Name:ANNIE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11685 ALPHARETTA HWY
Mailing Address - Street 2:SUITE120
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4913
Mailing Address - Country:US
Mailing Address - Phone:770-284-3150
Mailing Address - Fax:770-284-3170
Practice Address - Street 1:11685 ALPHARETTA HWY
Practice Address - Street 2:SUITE120
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4913
Practice Address - Country:US
Practice Address - Phone:770-284-3150
Practice Address - Fax:770-284-3170
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121505207R00000X, 207RR0500X
GA76341207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G669589OtherMEDICARE PTAN GROUP
GA202I662478OtherMEDICARE PTAN INDIVIDUAL
IL036121505Medicaid