Healthcare Provider Details

I. General information

NPI: 1760980940
Provider Name (Legal Business Name): JOSHUA KYLE FRANKLIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH STREET
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

70 COUNTRY CLUB DR
FORSYTH GA
31029-3103
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-3871
  • Fax:
Mailing address:
  • Phone: 706-318-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN220093
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN220093
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: