Provider Demographics
NPI:1881972982
Name:HARRY, FRANKLIN W (DPM)
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:W
Last Name:HARRY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 US HIGHWAY 61 STE A
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4158
Mailing Address - Country:US
Mailing Address - Phone:636-224-8297
Mailing Address - Fax:
Practice Address - Street 1:1455 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4157
Practice Address - Country:US
Practice Address - Phone:845-520-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00378213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP01421419OtherRAILROAD MEDICARE
ILP01421408OtherRAILROAD MEDICARE
MO1881972982Medicaid
MOP01421419OtherRAILROAD MEDICARE
ILF400174004Medicare PIN
MO149630011Medicare PIN