Provider Demographics
NPI:1457142523
Name:EDENS, FRANKIE ALLEN JR
Entity type:Individual
Prefix:
First Name:FRANKIE
Middle Name:ALLEN
Last Name:EDENS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-4803
Mailing Address - Country:US
Mailing Address - Phone:731-798-0850
Mailing Address - Fax:
Practice Address - Street 1:1711 MERIWEATHER DR STE 104
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7789
Practice Address - Country:US
Practice Address - Phone:731-798-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program