Provider Demographics
NPI:1366441404
Name:CHARNEY, FRANKLIN JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:JEFFREY
Last Name:CHARNEY
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 1:3321 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6817
Mailing Address - Country:US
Mailing Address - Phone:940-382-7321
Mailing Address - Fax:940-382-5453
Practice Address - Street 1:3321 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6817
Practice Address - Country:US
Practice Address - Phone:940-382-7321
Practice Address - Fax:940-382-5453
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9571174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115768701Medicaid
TX826081400OtherR.R. MEDICARE
TX80Y770OtherB/C & B/S
TX10029837OtherAMERICAID
TX4057670OtherAETNA
TX3614842002OtherCIGNA
TX80Y770Medicare ID - Type Unspecified
TX115768701Medicaid