Provider Demographics
NPI:1003263252
Name:FRANKLIN, JERRY
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 ELMHURST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:809 ELMHURST BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7405
Practice Address - Country:US
Practice Address - Phone:785-914-5491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-096751835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric