Provider Demographics
NPI:1922007095
Name:MIRRER, FRANKLIN E (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:E
Last Name:MIRRER
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 1:215 TOLL GATE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4458
Mailing Address - Country:US
Mailing Address - Phone:401-739-9050
Mailing Address - Fax:401-732-2203
Practice Address - Street 1:215 TOLL GATE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4458
Practice Address - Country:US
Practice Address - Phone:401-739-9050
Practice Address - Fax:401-732-2203
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI10668207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7009100Medicaid
RI7009100Medicaid
RIH40878Medicare UPIN