Provider Demographics
NPI:1205841962
Name:TERENCE G. TEMPLETON, O.D., INC.
Entity Type:Organization
Organization Name:TERENCE G. TEMPLETON, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-625-6300
Mailing Address - Street 1:1206 HULL RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-6061
Mailing Address - Country:US
Mailing Address - Phone:419-625-6300
Mailing Address - Fax:419-625-8901
Practice Address - Street 1:1206 HULL RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-6061
Practice Address - Country:US
Practice Address - Phone:419-625-6300
Practice Address - Fax:419-625-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3390T234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH04715OtherPARAMOUNT HEALTH CARE
OH282541744001OtherMEDICAL MUTUAL/HMO OHIO
OH0757926Medicaid
OH000000330580OtherANTHEM BLUE CROSS/BLUE SH
OH0757926Medicaid
OH000000330580OtherANTHEM BLUE CROSS/BLUE SH