Healthcare Provider Details

I. General information

NPI: 1043239734
Provider Name (Legal Business Name): KENDRA MARSHAE FRANKLIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD DEPARTMENT OF RADIOLOGY, ATLANTA VA MEDICAL CENTER
DECATUR GA
30033-4004
US

IV. Provider business mailing address

1831 WALNUT GROVE LN
TUCKER GA
30084-5945
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax:
Mailing address:
  • Phone: 770-696-2150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: