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NPI Code Detail

MEDICARE: FRANKLIN HARRISON DO

MEDICARE: FRANKLIN HARRISON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036076625IL

General Provider Information

NPI Number : 1316211345
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRANKLIN HARRISON DO
Provider Business Mailing Address
First Line : PO BOX 767
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-0015
Country : US
Telephone Number : 618-244-2000
Fax Number : 618-244-6625
Provider Business Practice Location Address
First Line : 2712 BROADWAY ST
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-2342
Country : US
Telephone Number : 618-244-2000
Fax Number : 618-244-6625
Authorized Official
Title or Position : OWNER
Name : DR. FRANKLIN HARRISON
Credential : DO
Telephone Number : 618-244-2000
Provider Enumeration Date : 03/08/2012
Last Update Date : 03/08/2012

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