Provider Demographics
NPI:1790974350
Name:TEMPLETON, JESSE ELLIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ELLIS
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:24723 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2526
Mailing Address - Country:US
Mailing Address - Phone:440-892-1440
Mailing Address - Fax:440-892-9083
Practice Address - Street 1:24723 DETROIT RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2526
Practice Address - Country:US
Practice Address - Phone:440-892-1440
Practice Address - Fax:440-892-9083
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036123670207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1633878OtherBCBS
IL9426390OtherAETNA
IL1633878OtherBCBS
IL207073008 (207073)Medicare UPIN