MEDICARE: DR. FRANKLIN L BRODY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS001928L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OS001928L	OTHER	PA	STATE LICENSE

General Provider Information

NPI Number	:	1316980733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANKLIN L BRODY DO

Provider Business Mailing Address
First Line	:	700 SURAL LN
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1404
Country	:	US
Telephone Number	:	215-242-2256
Fax Number	:	215-242-8833

Provider Business Practice Location Address
First Line	:	8501 WILLIAMS AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-1912
Country	:	US
Telephone Number	:	215-242-2256
Fax Number	:	215-242-8833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	12/11/2007

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