MEDICARE: TEMPLE MEDICAL CLINIC, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CG2343	OTHER	AL	MEDICARE TRAVELERS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477629434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE MEDICAL CLINIC, PC

Provider Business Mailing Address
First Line	:	859 AIRPORT DRIVE
Second Line	:
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3443
Country	:	US
Telephone Number	:	256-234-4295
Fax Number	:	256-329-1024

Provider Business Practice Location Address
First Line	:	859 AIRPORT DRIVE
Second Line	:
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3443
Country	:	US
Telephone Number	:	256-234-4295
Fax Number	:	256-329-1024

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES PITTS TEMPLE
Credential	:	M.D.
Telephone Number	:	256-234-4295

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	11/07/2011

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