Provider Demographics
NPI:1326347212
Name:FRANKLIN, JEFFERY MICHAEL
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:MICHAEL
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 1:8894 AIRLINE HWY STE Q
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4081
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:
Practice Address - Street 1:3225 DANNY PARK STE 100
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5751
Practice Address - Country:US
Practice Address - Phone:504-889-0550
Practice Address - Fax:504-889-0582
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301386207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2150162Medicaid