Healthcare Provider Details

I. General information

NPI: 1851841662
Provider Name (Legal Business Name): TEMPLE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E ALLEGHENY AVE
PHILADELPHIA PA
19134-4433
US

IV. Provider business mailing address

2450 W HUNTING PARK AVE 2ND FLOOR TPI
PHILADELPHIA PA
19129-1302
US

V. Phone/Fax

Practice location:
  • Phone: 215-423-6670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD017012E
License Number StatePA

VIII. Authorized Official

Name: RICHARD VAUGHN
Title or Position: LEAD CREDENTIALING SPECIALIST
Credential:
Phone: 215-926-9019