Provider Demographics
NPI:1457311573
Name:FRANKLIN, BENJAMIN JORDAN (OD, MPH, FAAO)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JORDAN
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:OD, MPH, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WHASC 59 MDW
Mailing Address - Street 2:1100 WILFORD HALL LOOP, BLDG 4554
Mailing Address - City:JBSA LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236
Mailing Address - Country:US
Mailing Address - Phone:210-292-6582
Mailing Address - Fax:
Practice Address - Street 1:559 MDG/559 THLS
Practice Address - Street 2:1100 WILFORD HALL LOOP, BLDG 4554
Practice Address - City:JBSA LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-292-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9152T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist