Basic Information
Provider Information
NPI: 1790949477
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESGUERRA
FirstName: FRANCIS
MiddleName: PAUL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6920 POINTE INVERNESS WAY STE 200
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468047934
CountryCode: US
TelephoneNumber: 2604793516
FaxNumber: 2604793520
Practice Location
Address1: 10307 DUPONT CIRCLE DR W STE A
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468251633
CountryCode: US
TelephoneNumber: 2604583440
FaxNumber: 2604583441
Other Information
ProviderEnumerationDate: 07/11/2008
LastUpdateDate: 03/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X01071018AINY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
20109101005IN MEDICAID


Home