Healthcare Provider Details

I. General information

NPI: 1316497027
Provider Name (Legal Business Name): FRANKLIN PRIMARY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 ELLIOTT ST
BREWTON AL
36426-1336
US

IV. Provider business mailing address

1303 DR MARTIN L KING JR AVE
MOBILE AL
36603-5341
US

V. Phone/Fax

Practice location:
  • Phone: 251-255-5830
  • Fax: 251-867-9985
Mailing address:
  • Phone: 251-964-4011
  • Fax: 251-964-4012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateAL
# 6
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES N/A WHITE
Title or Position: CEO
Credential:
Phone: 251-432-4117