Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | LL35910 | SC |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 35910 | SC |
NPI | 1174962591 |
---|---|
Provider Name | Feneisha Isalyn Franklin |
First Address | Atlanta, GA 30384-2145 |
Second Address | West Columbia, SC 29169-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2013 |
Last Update Date | 15/02/2021 |