MEDICARE: PAMELA H TEMPLES MD

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	207V00000X	Obstetrics & Gynecology Physician	053045	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1740366442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA H TEMPLES MD

Provider Business Mailing Address
First Line	:	814 NORTHWOOD PARK DR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-1398
Country	:	US
Telephone Number	:	229-262-6810
Fax Number	:	229-219-1634

Provider Business Practice Location Address
First Line	:	814 NORTHWOOD PARK DR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-1398
Country	:	US
Telephone Number	:	229-262-6810
Fax Number	:	229-219-1634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	01/25/2023

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