Provider Demographics
NPI:1144284720
Name:FRANKLIN D. ROBERTS,M.D.,P.A.
Entity type:Organization
Organization Name:FRANKLIN D. ROBERTS,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:DOWLING
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-234-8430
Mailing Address - Street 1:1327 N WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-2067
Mailing Address - Country:US
Mailing Address - Phone:870-234-8430
Mailing Address - Fax:870-234-1417
Practice Address - Street 1:1327 N WASHINGTON
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2067
Practice Address - Country:US
Practice Address - Phone:870-234-8430
Practice Address - Fax:870-234-1417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-5093173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR57494OtherAR BLUE CROSS BLUE SHIELD
ARD08982Medicare UPIN
AR57494OtherAR BLUE CROSS BLUE SHIELD