Provider Demographics
NPI:1700837754
Name:FRANKLIN, JON G (OD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:G
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3011
Mailing Address - Country:US
Mailing Address - Phone:615-754-4733
Mailing Address - Fax:615-758-7515
Practice Address - Street 1:3458 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3011
Practice Address - Country:US
Practice Address - Phone:615-754-4733
Practice Address - Fax:615-758-7515
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD001492152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3599119Medicare ID - Type Unspecified
TNU4818Medicare UPIN