Healthcare Provider Details
I. General information
NPI: 1851752935
Provider Name (Legal Business Name): FRANKLIN DELANO HURT JR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/16/2016
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
547 E 11TH AVE
COLUMBUS OH
43211-2603
US
IV. Provider business mailing address
547 E 11TH AVE
COLUMBUS OH
43211-2603
US
V. Phone/Fax
- Phone: 614-224-4506
- Fax: 614-291-0118
- Phone: 614-224-4506
- Fax: 614-291-0118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 4163 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: