Provider Demographics
NPI:1083932628
Name:TEMPLIN EYE CARE, PC
Entity Type:Organization
Organization Name:TEMPLIN EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TEMPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-866-2030
Mailing Address - Street 1:5 E LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MYERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17067-1108
Mailing Address - Country:US
Mailing Address - Phone:717-866-2030
Mailing Address - Fax:717-866-2818
Practice Address - Street 1:5 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MYERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17067-1108
Practice Address - Country:US
Practice Address - Phone:717-866-2030
Practice Address - Fax:717-866-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA0007342T261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU53059Medicare UPIN