Provider Demographics
NPI:1831172949
Name:FRANKLIN, KIMBERLY M (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:M
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:M
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:747 E COUNTY LINE RD STE D
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1082
Practice Address - Country:US
Practice Address - Phone:317-888-9669
Practice Address - Fax:317-885-7966
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056743A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200407190Medicaid
217530AMedicare ID - Type Unspecified
IN200407190Medicaid