Healthcare Provider Details

I. General information

NPI: 1154416089
Provider Name (Legal Business Name): ARCH W TEMPLETON, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 REYNOLDS RD
BARNWELL SC
29812-1573
US

IV. Provider business mailing address

PO BOX 100523
FLORENCE SC
29501-0523
US

V. Phone/Fax

Practice location:
  • Phone: 843-669-5162
  • Fax: 843-667-4573
Mailing address:
  • Phone: 843-669-5162
  • Fax: 843-667-4573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number10634
License Number StateSC

VIII. Authorized Official

Name: ARCH W TEMPLETON
Title or Position: PRESIDENT - MD - OWNER
Credential: MD
Phone: 843-669-5162