Provider Demographics
NPI:1124150446
Name:BROSGOL, FRANKLIN L (MD)
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:L
Last Name:BROSGOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:FLINT HILL
Mailing Address - State:VA
Mailing Address - Zip Code:22627-0609
Mailing Address - Country:US
Mailing Address - Phone:540-635-2783
Mailing Address - Fax:
Practice Address - Street 1:6 DAHLGREN LANE
Practice Address - Street 2:
Practice Address - City:HUNTLY
Practice Address - State:VA
Practice Address - Zip Code:22640
Practice Address - Country:US
Practice Address - Phone:540-635-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine