Healthcare Provider Details

I. General information

NPI: 1265446983
Provider Name (Legal Business Name): TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 N 8TH ST
PHILADELPHIA PA
19107-2418
US

IV. Provider business mailing address

148 NORTH 8TH STREET
PHILADELPHIA PA
19182-7282
US

V. Phone/Fax

Practice location:
  • Phone: 215-777-5808
  • Fax: 215-777-5825
Mailing address:
  • Phone: 215-777-5808
  • Fax: 215-777-5825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: MR. RODERICK B. JONES
Title or Position: SR VICE DEAN
Credential:
Phone: 215-777-5732