Provider Demographics
NPI:1467287276
Name:FAUST, FRANKLIN FORREST IV
Entity type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:FORREST
Last Name:FAUST
Suffix:IV
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 1:1200 WOODCREST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44319-2652
Mailing Address - Country:US
Mailing Address - Phone:330-541-1477
Mailing Address - Fax:
Practice Address - Street 1:1200 WOODCREST AVE
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44319-2652
Practice Address - Country:US
Practice Address - Phone:330-541-1477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP938374347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle