Provider Demographics
NPI:1760711998
Name:TEMPLE PHYSICIANS INC
Entity Type:Organization
Organization Name:TEMPLE PHYSICIANS INC
Other - Org Name:JEANES BARIATRIC SURGERY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-926-9050
Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:2ND TPI ATTN: D KESSLER
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-926-9022
Mailing Address - Fax:215-226-8286
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1219
Practice Address - Country:US
Practice Address - Phone:215-750-3140
Practice Address - Fax:215-757-5870
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-17
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA597586Medicare PIN
PACD4829Medicare PIN