Provider Demographics
NPI:1316116460
Name:FRANKLIN, TONY R (PHD, MSM, BA)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:R
Last Name:FRANKLIN
Suffix:
Gender:
Credentials:PHD, MSM, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610A RUCKER BLVD
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2277
Mailing Address - Country:US
Mailing Address - Phone:334-494-6925
Mailing Address - Fax:334-255-7210
Practice Address - Street 1:301 ANDREWS AVENUE
Practice Address - Street 2:PRIMARY CARE CLINIC, RM E-107
Practice Address - City:FT RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362
Practice Address - Country:US
Practice Address - Phone:334-255-7125
Practice Address - Fax:334-255-7210
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL720103TF0000X, 103TP2701X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy