Provider Demographics
NPI:1639131972
Name:FRANKLIN, QUENTIN (MD)
Entity Type:Individual
Prefix:
First Name:QUENTIN
Middle Name:
Last Name:FRANKLIN
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 1:3921 GRANBY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-1201
Mailing Address - Country:US
Mailing Address - Phone:757-583-5826
Mailing Address - Fax:
Practice Address - Street 1:3921 GRANBY ST
Practice Address - Street 2:SUITE A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504
Practice Address - Country:US
Practice Address - Phone:757-583-5826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236236896207W00000X
NC2011-00185207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10842Medicare PIN