Healthcare Provider Details

I. General information

NPI: 1912964370
Provider Name (Legal Business Name): FRANKLIN ALEXY SALIBA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N 7TH ST
CORDELE GA
31015-3234
US

IV. Provider business mailing address

PO BOX 3184
SPRINGFIELD IL
62708-3184
US

V. Phone/Fax

Practice location:
  • Phone: 229-276-3100
  • Fax: 229-271-4654
Mailing address:
  • Phone: 866-444-0850
  • Fax: 941-269-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number027972
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN180265
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: