Provider Demographics
NPI:1518150374
Name:FRANKLIN, CRYSTAL L (OD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:L
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8247 OCEAN HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6994
Mailing Address - Country:US
Mailing Address - Phone:843-314-9064
Mailing Address - Fax:843-314-9066
Practice Address - Street 1:8247 OCEAN HWY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6994
Practice Address - Country:US
Practice Address - Phone:843-314-9064
Practice Address - Fax:843-314-9066
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1470152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA25980281Medicare UPIN