Healthcare Provider Details

I. General information

NPI: 1336415496
Provider Name (Legal Business Name): JUSTIN PAUL TEMPLETON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 07/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF TENNESSEE 910 MADISON AVE, SUITE 1031
MEMPHIS TN
38163-0001
US

IV. Provider business mailing address

1711 GOLDEN FIELDS DR
GERMANTOWN TN
38138-2301
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-5814
  • Fax:
Mailing address:
  • Phone: 901-351-4538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: