Healthcare Provider Details

I. General information

NPI: 1598763633
Provider Name (Legal Business Name): FRANKLIN ALFREDO OLMO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 GRANVILLE ST
GAHANNA OH
43230-3000
US

IV. Provider business mailing address

1091 RIDGE PL
GAHANNA OH
43230-1897
US

V. Phone/Fax

Practice location:
  • Phone: 614-428-8585
  • Fax: 614-428-7784
Mailing address:
  • Phone: 614-855-8425
  • Fax: 614-428-7784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35068219
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: