Provider Demographics
NPI:1902855042
Name:TEMPLETON, PHILIP ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:ANTHONY
Last Name:TEMPLETON
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 1:1302 UPPER GLENCOE RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9371
Mailing Address - Country:US
Mailing Address - Phone:410-472-3275
Mailing Address - Fax:410-472-9477
Practice Address - Street 1:1302 UPPER GLENCOE RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9371
Practice Address - Country:US
Practice Address - Phone:410-472-3275
Practice Address - Fax:410-472-9477
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD302972085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB87215Medicare UPIN