Provider Demographics
NPI:1245204031
Name:MERRITT, FRANKLIN BROWN (MD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:BROWN
Last Name:MERRITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14302 MILLCOLE AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-2725
Mailing Address - Country:US
Mailing Address - Phone:334-790-0984
Mailing Address - Fax:
Practice Address - Street 1:14302 MILLCOLE AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-2725
Practice Address - Country:US
Practice Address - Phone:334-790-0984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22834207P00000X
FLME90738207P00000X
FLMD22834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51515764OtherBCBS OF ALABAMA
000904472BOtherGEORGIA MEDICAID
AL051515764Medicaid
FLCG636ZOtherFL MEDICARE
262626800OtherFLORIDA MEDICAID
MS03185073OtherMEDICAID
P00055583OtherRAILROAD MEDICARE
MS03185073OtherMEDICAID
AL51515764OtherBCBS OF ALABAMA