MEDICARE: TEMPLE HEALTHCARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	039012	GA

General Provider Information

NPI Number	:	1164627923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	2296 HENDERSON MILL RD NE
Second Line	:	SUITE 303
City	:	ATLANTA
State	:	GA
Zip	:	30345-2739
Country	:	US
Telephone Number	:	678-387-5292
Fax Number	:

Provider Business Practice Location Address
First Line	:	2296 HENDERSON MILL RD NE
Second Line	:	SUITE 303
City	:	ATLANTA
State	:	GA
Zip	:	30345-2739
Country	:	US
Telephone Number	:	678-387-5292
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WINSOME D WHITTAKER
Credential	:	M.D.
Telephone Number	:	678-387-5292

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	08/22/2020

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