Healthcare Provider Details
I. General information
NPI: 1720130990
Provider Name (Legal Business Name): TEMPLE PHYSICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2007
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 E ALLEGHENY AVE SUITE 180
PHILADELPHIA PA
19134-4427
US
IV. Provider business mailing address
2301 E ALLEGHENY AVE SUITE 180
PHILADELPHIA PA
19134-4427
US
V. Phone/Fax
- Phone: 215-926-3700
- Fax: 215-926-3703
- Phone: 215-926-3700
- Fax: 215-926-3703
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LYNNIE
SAVERING
Title or Position: DIRECTOR
Credential:
Phone: 215-926-9015