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General NPI Number Information
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NPI Number | 1619906179
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Entity Type | Individual
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Provider Name | JOHNNY B FRANKLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 1110 BROAD AVE SUITE 700
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City | GULFPORT
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State | MS
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Zip | 39501-8907
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Country | US
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Telephone | 228-385-4645
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Fax | 228-385-4695
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Provider Business Mailing Address
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Address Line | PO BOX 1810
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City | GULFPORT
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State | MS
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Zip | 39502-1810
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Country | US
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Telephone | 228-865-1453
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Fax | 228-865-1451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 09110
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License Number State | MS
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