Healthcare Provider Details

I. General information

NPI: 1679543433
Provider Name (Legal Business Name): RONALD DAVID FRANKLIN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 MACDOUGALL DRIVE SEVEN LAKES VILLAGE
WEST END NC
27376
US

IV. Provider business mailing address

PO BOX 246
CANDOR NC
27229-0246
US

V. Phone/Fax

Practice location:
  • Phone: 910-673-2803
  • Fax: 910-974-4113
Mailing address:
  • Phone: 910-220-2293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1363
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1363
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number1363
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number1363
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number1636
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: