Provider Demographics
NPI:1427000652
Name:FRANKLIN FAMILY PRACTICE PA
Entity type:Organization
Organization Name:FRANKLIN FAMILY PRACTICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BLECKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-369-4244
Mailing Address - Street 1:161 IOTLA STREET
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734
Mailing Address - Country:US
Mailing Address - Phone:828-369-4244
Mailing Address - Fax:828-349-6767
Practice Address - Street 1:161 IOTLA STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-421-0460
Practice Address - Fax:828-349-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0164YOtherBCBSNC
NC890164YMedicaid
NC2319102Medicare ID - Type Unspecified