Provider Demographics
NPI:1194710491
Name:STUMBO, FRANKLIN R (PT)
Entity type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:R
Last Name:STUMBO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:149 MEDICAL PLAZA LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858
Mailing Address - Country:US
Mailing Address - Phone:606-632-1188
Mailing Address - Fax:606-632-0075
Practice Address - Street 1:10824 US HIGHWAY 23 S STE 102
Practice Address - Street 2:
Practice Address - City:BETSY LAYNE
Practice Address - State:KY
Practice Address - Zip Code:41605-7062
Practice Address - Country:US
Practice Address - Phone:606-478-1111
Practice Address - Fax:606-478-1113
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY003789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0916201Medicare PIN
P05652Medicare UPIN
KY0667503Medicare PIN