Provider Demographics
NPI:1619926508
Name:TEMPLETON, TERRY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:PAUL
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TERRY
Other - Middle Name:PAUL
Other - Last Name:TEMPLETON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2120 EXETER RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3922
Mailing Address - Country:US
Mailing Address - Phone:901-757-9500
Mailing Address - Fax:901-757-9150
Practice Address - Street 1:2120 EXETER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3922
Practice Address - Country:US
Practice Address - Phone:901-757-9500
Practice Address - Fax:901-757-9150
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8379207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3176498Medicaid
TNB03709Medicare UPIN
TN3176498Medicaid