Provider Demographics
NPI:1629702782
Name:FRANKLIN PEDIATRIC CLINIC, PLLC
Entity Type:Organization
Organization Name:FRANKLIN PEDIATRIC CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR/MD
Authorized Official - Prefix:
Authorized Official - First Name:SHASHIREKHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-203-8750
Mailing Address - Street 1:100 COVEY DR STE 310
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5663
Mailing Address - Country:US
Mailing Address - Phone:615-203-8750
Mailing Address - Fax:615-472-8588
Practice Address - Street 1:100 COVEY DR STE 310
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5663
Practice Address - Country:US
Practice Address - Phone:615-203-8750
Practice Address - Fax:615-472-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty