Provider Demographics
NPI:1619134210
Name:TEMPLETON, JAMES STEPHEN (LDO)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STEPHEN
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5433 HIGHWAY 53
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-3122
Mailing Address - Country:US
Mailing Address - Phone:706-658-0270
Mailing Address - Fax:706-658-0273
Practice Address - Street 1:5433 HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-3122
Practice Address - Country:US
Practice Address - Phone:706-658-0270
Practice Address - Fax:706-658-0273
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA953156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician