1497807739 NPI number — TEMPLE PHYSICIANS INC.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497807739 NPI number — TEMPLE PHYSICIANS INC.

Employer Identification Number (EIN):

Provider Organization Name:

TEMPLE PHYSICIANS INC.

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1497807739

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

06/29/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 820933

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

PHILADELPHIA

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

19182-0933

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

215-926-9010

Provider Business Mailing Address Fax Number:

215-226-8285

Provider First Line Business Practice Location Address:

7600 CENTRAL AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

PHILADELPHIA

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

19111-2442

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

215-728-2000

Provider Business Practice Location Address Fax Number:

215-214-4119

Provider Enumeration Date:

01/17/2007

Authorized Official Last Name:

VAUGHN

Authorized Official First Name:

RICHARD

Authorized Official Middle Name:

Authorized Official Title or Position:

LEAD CRED SPECIALIST

Authorized Official Telephone Number:

215-926-9019

• Taxonomy code: 207LC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1962007 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0756985000 . This is a "IBC (KHPE & PC)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 34477 . This is a "HEALTH PARTNERS SITE #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 3466024 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 100727800 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 7203513 . This is a "AETNA PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 15383 . This is a "ELDER HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 30008514 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: CD4829 . This is a "RRM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".