Provider Demographics
NPI:1669838306
Name:FRANKLIN, GAIL
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:
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 228
Mailing Address - Street 2:
Mailing Address - City:ALLENHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31301-0228
Mailing Address - Country:US
Mailing Address - Phone:912-980-0319
Mailing Address - Fax:
Practice Address - Street 1:215 HARGROVE LN
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:GA
Practice Address - Zip Code:31320-3937
Practice Address - Country:US
Practice Address - Phone:912-980-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA46-0962015172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker