Healthcare Provider Details

I. General information

NPI: 1326088956
Provider Name (Legal Business Name): JONATHAN FRANKLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CENTRAL EXPY N
ALLEN TX
75013-6103
US

IV. Provider business mailing address

PO BOX 8549
FORT WORTH TX
76124-0549
US

V. Phone/Fax

Practice location:
  • Phone: 972-747-6552
  • Fax:
Mailing address:
  • Phone: 817-451-4208
  • Fax: 817-496-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberL0181
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: