Provider Demographics
NPI:1245587534
Name:FRENCH BROAD PEDIATRIC ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:FRENCH BROAD PEDIATRIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-348-8232
Mailing Address - Street 1:40 N MERRIMON AVE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1368
Mailing Address - Country:US
Mailing Address - Phone:828-348-8232
Mailing Address - Fax:855-323-6740
Practice Address - Street 1:40 N MERRIMON AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1368
Practice Address - Country:US
Practice Address - Phone:828-348-8232
Practice Address - Fax:855-323-6740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000996208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12886OtherBCBS NC
NC34D2053302OtherCLIA#
NC5922037Medicaid