Basic Information
| Provider Information | |||||||||
| NPI: | 1750320560 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MENCL | ||||||||
| FirstName: | FRANCIS | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 858 | ||||||||
| Address2: | MC A410 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170330858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
| FaxNumber: | 7175314587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 02/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35062004 | OH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD469591 | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 930023439 | 01 | OH | RR MEDICARE | OTHER | 000000138510 | 01 | OH | ANTHEM | OTHER | 341779226002 | 01 | OH | MED MUT OF OH/ 1 OF 2 | OTHER | 0849452 | 05 | OH | MEDICAID | 61641 | 01 | OH | UNITED HEALTHCARE | OTHER | 340714755XX | 01 | OH | SUMMACARE | OTHER | 341779226003 | 01 | OH | MED MUT OF OH/ 2 OF 2 | OTHER |