Provider Demographics
NPI:1144263245
Name:KILLINGSWORTH, FRANKLIN W (PA-C)
Entity type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:W
Last Name:KILLINGSWORTH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1538 13TH AVE
Mailing Address - Street 2:STE B300
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2563
Mailing Address - Country:US
Mailing Address - Phone:706-321-9300
Mailing Address - Fax:706-243-1284
Practice Address - Street 1:2300 MANCHESTER EXPY STE A006
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6805
Practice Address - Country:US
Practice Address - Phone:706-596-4225
Practice Address - Fax:706-323-3425
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA003580363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL600-49721OtherBLUE CROSS BLUE SHIELD OF ALABAMA
AL170995Medicaid
GA827867653DMedicaid
GAQ23043Medicare UPIN
AL170995Medicaid