Provider Demographics
NPI:1679543433
Name:FRANKLIN, RONALD DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DAVID
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:PHD
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 246
Mailing Address - Street 2:
Mailing Address - City:CANDOR
Mailing Address - State:NC
Mailing Address - Zip Code:27229-0246
Mailing Address - Country:US
Mailing Address - Phone:910-220-2293
Mailing Address - Fax:
Practice Address - Street 1:116 MACDOUGALL DRIVE
Practice Address - Street 2:SEVEN LAKES VILLAGE
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376
Practice Address - Country:US
Practice Address - Phone:910-673-2803
Practice Address - Fax:910-974-4113
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1363103G00000X, 103TC0700X, 103TF0200X, 103TH0004X
NC1636103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHSP-P 1363OtherPSYCHOLOGY LICENSE
NCHSP-P 1363OtherPSYCHOLOGY LICENSE