Healthcare Provider Details

I. General information

NPI: 1538173471
Provider Name (Legal Business Name): COOKEVILLE PEDIATRIC ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N WILLOW AVE
COOKEVILLE TN
38501-2368
US

IV. Provider business mailing address

150 N WILLOW AVE
COOKEVILLE TN
38501-2368
US

V. Phone/Fax

Practice location:
  • Phone: 931-528-1485
  • Fax: 931-526-4233
Mailing address:
  • Phone: 931-528-1485
  • Fax: 931-526-4233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number208000000X
License Number StateTN

VIII. Authorized Official

Name: DR. LLOYD DOUGLAS FRANKLIN
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 931-265-5836