Provider Demographics
NPI:1821314626
Name:TEMPLE, ANTHONY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:TEMPLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 WESLEY POWELL DR.
Mailing Address - Street 2:
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7844
Mailing Address - Country:US
Mailing Address - Phone:435-688-1057
Mailing Address - Fax:
Practice Address - Street 1:1027 WESLEY POWELL DR.
Practice Address - Street 2:
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7844
Practice Address - Country:US
Practice Address - Phone:435-688-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT151005-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics