Provider Demographics
NPI:1477563369
Name:IRWIN, FRANKLIN LEE JR (MD)
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:LEE
Last Name:IRWIN
Suffix:JR
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 1:7855 ARGYLE FOREST BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5597
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-619-1080
Practice Address - Street 1:11555 CENTRAL PARKWAY
Practice Address - Street 2:SUITE 304
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224
Practice Address - Country:US
Practice Address - Phone:904-265-7755
Practice Address - Fax:904-265-7754
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105673208100000X, 208VP0014X
DEC1-0007425208VP0014X
FLME1158172081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000038179Medicaid
MDMDCI2358OtherRAILROAD MEDICARE
FL008912600Medicaid
DEDECF8249OtherRAILROAD MEDICARE
CA409525100Medicaid
CA409525100Medicaid
DE1000038179Medicaid
DE017352M28Medicare ID - Type Unspecified
DEI33758Medicare UPIN