Provider Demographics
NPI:1033214267
Name:FRANKLIN, LATRINIA HUNT (PA)
Entity Type:Individual
Prefix:
First Name:LATRINIA
Middle Name:HUNT
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 DAUPHIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1769
Mailing Address - Country:US
Mailing Address - Phone:251-410-1188
Mailing Address - Fax:251-414-5571
Practice Address - Street 1:100 MEMORIAL HOSPITAL DR STE 2A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1199
Practice Address - Country:US
Practice Address - Phone:251-343-9090
Practice Address - Fax:251-380-1015
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10567RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-39313OtherBCBS
AL153467Medicaid
LA1628671Medicaid