Provider Demographics
NPI:1225006521
Name:FRANKLIN, SHANNON CAMPBELL (OD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:CAMPBELL
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CLAREMONT LANE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932
Mailing Address - Country:US
Mailing Address - Phone:434-823-4441
Mailing Address - Fax:434-823-7620
Practice Address - Street 1:300 CLAREMONT LANE
Practice Address - Street 2:SUITE 102
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932
Practice Address - Country:US
Practice Address - Phone:434-823-4441
Practice Address - Fax:434-823-7620
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001030152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10015958OtherOPTIMA
VA446697OtherSOUTHERN HEALTH/COVENTRY
VA247048OtherBLUE CROSS, BLUE SHIELD/ANTHEM
VA0007619217OtherAETNA
VA6007250001OtherDMERC MEDICARE
VA00X336C01Medicare PIN
VA10015958OtherOPTIMA