Provider Demographics
NPI:1346804812
Name:TEMPLE, JORDYN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:ELIZABETH
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 S HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-3018
Mailing Address - Country:US
Mailing Address - Phone:479-524-3141
Mailing Address - Fax:
Practice Address - Street 1:451 S HOLLY ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3018
Practice Address - Country:US
Practice Address - Phone:479-524-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34950207Q00000X, 390200000X
390200000X
ARE-15392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program