Provider Demographics
NPI:1720392947
Name:TEMPLETON, HORACE WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:HORACE
Middle Name:WAYNE
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1605 MULKEY RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1127
Mailing Address - Country:US
Mailing Address - Phone:770-948-4455
Mailing Address - Fax:770-819-8824
Practice Address - Street 1:1605 MULKEY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1127
Practice Address - Country:US
Practice Address - Phone:770-948-4455
Practice Address - Fax:770-819-8824
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA017654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD46827Medicare UPIN