Healthcare Provider Details
I. General information
NPI: 1659422996
Provider Name (Legal Business Name): TEMPLE PHYSICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2007
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
133 W HUNTING PARK AVE SUITE 300-A
PHILADELPHIA PA
19140-2717
US
IV. Provider business mailing address
PO BOX 820933
PHILADELPHIA PA
19182-0933
US
V. Phone/Fax
- Phone: 215-324-0600
- Fax: 215-324-2795
- Phone: 215-926-9000
- Fax: 215-226-8285
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LYNNIE
SAVERING
Title or Position: DIRECTOR
Credential:
Phone: 215-926-9015