Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 024653 | GA |
NPI | 1003848524 |
---|---|
Provider Name | Franklyn Philip Bousquet III |
First Address | Savannah, GA 31405-5815 |
Second Address | Savannah, GA 31419-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 16/06/2009 |