Provider Demographics
NPI:1639274723
Name:ANTHONY W. SHEPLAY, MD, DBA: TEMPLETON SURGERY CENTER
Entity Type:Organization
Organization Name:ANTHONY W. SHEPLAY, MD, DBA: TEMPLETON SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-434-5428
Mailing Address - Street 1:1105 LAS TABLAS RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9731
Mailing Address - Country:US
Mailing Address - Phone:805-434-5428
Mailing Address - Fax:
Practice Address - Street 1:1105 LAS TABLAS RD
Practice Address - Street 2:SUITE E
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9731
Practice Address - Country:US
Practice Address - Phone:805-434-5428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5051165A261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051165AOtherMEDICARE PTAN
CAS051165AOtherMEDICARE PTAN