Healthcare Provider Details

I. General information

NPI: 1588662308
Provider Name (Legal Business Name): RUFUS HENRY TEMPLE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GREENFIELD ST
WILMINGTON NC
28401-6456
US

IV. Provider business mailing address

1650 GREENFIELD ST
WILMINGTON NC
28401-6456
US

V. Phone/Fax

Practice location:
  • Phone: 910-798-3500
  • Fax: 910-798-7834
Mailing address:
  • Phone: 910-798-3500
  • Fax: 910-798-7834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20978
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: