Healthcare Provider Details

I. General information

NPI: 1518176510
Provider Name (Legal Business Name): FRANKLIN CHARLES MARGARON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 BERKLEY RD
INDIANAPOLIS IN
46208-3708
US

IV. Provider business mailing address

3828 PUREBRED DR
VIRGINIA BEACH VA
23453-8529
US

V. Phone/Fax

Practice location:
  • Phone: 804-614-7155
  • Fax:
Mailing address:
  • Phone: 808-729-5175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116017804
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMD-18201
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: