Provider Demographics
NPI:1164627923
Name:TEMPLE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:TEMPLE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSOME
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITTAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-387-5292
Mailing Address - Street 1:2296 HENDERSON MILL RD NE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2739
Mailing Address - Country:US
Mailing Address - Phone:678-387-5292
Mailing Address - Fax:
Practice Address - Street 1:2296 HENDERSON MILL RD NE
Practice Address - Street 2:SUITE 303
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2739
Practice Address - Country:US
Practice Address - Phone:678-387-5292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039012207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G04025Medicare UPIN