Provider Demographics
NPI:1023015930
Name:FRANKLIN, RUDOLPH (MD)
Entity type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 GOVERNOR NICHOLLS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-2430
Mailing Address - Country:US
Mailing Address - Phone:985-641-9900
Mailing Address - Fax:985-641-4406
Practice Address - Street 1:1538 FRONT ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2724
Practice Address - Country:US
Practice Address - Phone:985-641-9900
Practice Address - Fax:985-641-4406
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04191R207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07729706Medicaid
LA180008685OtherRAILROAD MEDICARE
180008685OtherRAILROAD MEDICARE
LA51473OtherMEDICARE PROV
LA1194174Medicaid
MS180000107Medicare ID - Type Unspecified
LA180008685OtherRAILROAD MEDICARE