Provider Demographics
NPI:1174962591
Name:FRANKLIN, FENEISHA ISALYN (MD)
Entity type:Individual
Prefix:
First Name:FENEISHA
Middle Name:ISALYN
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FENEISHA
Other - Middle Name:
Other - Last Name:FERVIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:803-796-7270
Mailing Address - Fax:803-796-0106
Practice Address - Street 1:103 THOMPSON ST STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2543
Practice Address - Country:US
Practice Address - Phone:803-796-7270
Practice Address - Fax:803-796-0106
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35910207QG0300X
SCLL35910207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine