Healthcare Provider Details
I. General information
NPI: 1598727133
Provider Name (Legal Business Name): FRANKLIN M WEST DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
406 EAST ELM STREET
CARSON CITY MI
48811
US
IV. Provider business mailing address
406 EAST ELM STREET PO BOX 879
CARSON CITY MI
48811
US
V. Phone/Fax
- Phone: 989-584-3971
- Fax: 989-584-3729
- Phone: 989-584-3971
- Fax: 989-584-3729
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 5101009008 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: