Provider Demographics
NPI:1205005485
Name:FRANKLIN, DEVERICK
Entity Type:Individual
Prefix:
First Name:DEVERICK
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 1:745 OLD WARREN RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-9713
Mailing Address - Country:US
Mailing Address - Phone:870-460-7445
Mailing Address - Fax:870-460-7444
Practice Address - Street 1:745 OLD WARREN RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-9713
Practice Address - Country:US
Practice Address - Phone:870-460-7445
Practice Address - Fax:870-460-7444
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator