Healthcare Provider Details

I. General information

NPI: 1649232935
Provider Name (Legal Business Name): FRANKLIN D. DEMINT D. O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WARREN DR POB 646
KINGSTON OH
45644-9798
US

IV. Provider business mailing address

PO BOX 646
KINGSTON OH
45644-0646
US

V. Phone/Fax

Practice location:
  • Phone: 740-642-4154
  • Fax: 740-642-4156
Mailing address:
  • Phone: 740-642-4154
  • Fax: 740-642-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34005493D
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: