Provider Demographics
NPI:1952303539
Name:FRANKLIN DERMATOLOGY GROUP, PLC
Entity Type:Organization
Organization Name:FRANKLIN DERMATOLOGY GROUP, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LATOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-771-1881
Mailing Address - Street 1:740 COOL SPRINGS BLVD.
Mailing Address - Street 2:#200
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:615-771-1881
Mailing Address - Fax:615-771-0050
Practice Address - Street 1:740 COOL SPRINGS BLVD.
Practice Address - Street 2:#200
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-771-1881
Practice Address - Fax:615-771-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN124880OtherBCBS OF TN
3389851Medicare ID - Type Unspecified