Provider Demographics
NPI:1497807739
Name:TEMPLE PHYSICIANS INC.
Entity Type:Organization
Organization Name:TEMPLE PHYSICIANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD CRED SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-926-9019
Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-926-9010
Mailing Address - Fax:215-226-8285
Practice Address - Street 1:7600 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-728-2000
Practice Address - Fax:215-214-4119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE PHYSICIANS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-17
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1962007OtherHIGHMARK BLUE SHIELD
PA0756985000OtherIBC (KHPE & PC)
PA34477OtherHEALTH PARTNERS SITE #
PA3466024OtherAETNA HMO
PA100727800Medicaid
PA7203513OtherAETNA PPO
PA15383OtherELDER HEALTH
PA30008514OtherKEYSTONE MERCY
PACD4829OtherRRM
PA3466024OtherAETNA HMO
PA100727800Medicaid
PA34477OtherHEALTH PARTNERS SITE #