Provider Demographics
NPI:1659397669
Name:FRANKLIN, ODUS MARTIN (DO)
Entity Type:Individual
Prefix:
First Name:ODUS
Middle Name:MARTIN
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 294777
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-4777
Mailing Address - Country:US
Mailing Address - Phone:830-257-0795
Mailing Address - Fax:830-257-6386
Practice Address - Street 1:723 HILL COUNTRY DR
Practice Address - Street 2:SUITE C
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5904
Practice Address - Country:US
Practice Address - Phone:830-792-5800
Practice Address - Fax:830-896-2625
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80440YOtherBCBS
TX8X9190OtherBCBS
TX080162929Medicare PIN
TXP00431379Medicare PIN
TX8874M1Medicare PIN
TX8F5056Medicare PIN