MEDICARE: TEMPLE PHYSICIANS INC.

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01927	OTHER	PA	HEALTH PARTNERS SITE #
2	1961997	OTHER	PA	HIGHMARK BLUE SHIELD
3	5561583	OTHER	PA	AETNA PPO
4	30033849	OTHER	PA	KEYSTONE MERCY
5	CD4829	OTHER	PA	RRM
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	0000201	OTHER	PA	AETNA HMO
8	0756985039	OTHER	PA	IBC (KHPE & PC)

General Provider Information

NPI Number	:	1740332048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE PHYSICIANS INC.

Provider Business Mailing Address
First Line	:	PO BOX 820933
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-0933
Country	:	US
Telephone Number	:	215-926-9000
Fax Number	:	215-226-8285

Provider Business Practice Location Address
First Line	:	9892 BUSTLETON AVE STE 101
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-2138
Country	:	US
Telephone Number	:	215-676-2741
Fax Number	:	215-676-2796

Authorized Official
Title or Position	:	LEAD CRED SPECIALIST
Name	:	RICHARD VAUGHN
Credential	:
Telephone Number	:	215-926-9019

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	05/02/2019

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Directions to “TEMPLE PHYSICIANS INC. ” Practice Location

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