Healthcare Provider Details

I. General information

NPI: 1245288414
Provider Name (Legal Business Name): JOE W FRANKLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CROSS ST
MADISONVILLE TX
77864-2432
US

IV. Provider business mailing address

1028 WALTON DR
COLLEGE STATION TX
77840-2311
US

V. Phone/Fax

Practice location:
  • Phone: 936-348-2631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberL1044
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: