Provider Demographics
NPI:1265551626
Name:FRANKLIN, ALICE ROY (DO)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:ROY
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2459
Mailing Address - Country:US
Mailing Address - Phone:207-443-4471
Mailing Address - Fax:207-442-0407
Practice Address - Street 1:765 HIGH ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2459
Practice Address - Country:US
Practice Address - Phone:207-443-4471
Practice Address - Fax:207-442-0407
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1068207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME170260000Medicaid
MEME0026Medicare UPIN
ME170260000Medicaid