Provider Demographics
NPI:1457459604
Name:LEVIN, FRANKLIN L (OD,PC)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:L
Last Name:LEVIN
Suffix:
Gender:M
Credentials:OD,PC
Other - Prefix:DR
Other - First Name:FRANKLIN
Other - Middle Name:L
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD,PC
Mailing Address - Street 1:1770 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4658
Mailing Address - Country:US
Mailing Address - Phone:804-935-7700
Mailing Address - Fax:804-935-7704
Practice Address - Street 1:1770 N PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4658
Practice Address - Country:US
Practice Address - Phone:804-935-7700
Practice Address - Fax:804-935-7704
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000440152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010371325Medicaid
VA197599OtherANTHEM
VA0682430001OtherADMINISTAR FEDERAL
VAP00632334OtherRAILROAD MEDICARE
VA953179OtherAETNA
VASC0001067Medicare PIN
VA010371325Medicaid
VA197599OtherANTHEM