Provider Demographics
NPI:1124018353
Name:FRANKLIN, GREGG E (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:E
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4901 LANG AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4397
Mailing Address - Country:US
Mailing Address - Phone:505-822-3948
Mailing Address - Fax:505-246-0684
Practice Address - Street 1:4901 LANG AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4397
Practice Address - Country:US
Practice Address - Phone:505-822-3948
Practice Address - Fax:505-246-0684
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2005-04412085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM64670554Medicaid
NM344531119Medicare PIN
NM64670554Medicaid