Provider Demographics
NPI:1205884798
Name:TEMPLE STREET FAMILY PRACTICE P.C.
Entity type:Organization
Organization Name:TEMPLE STREET FAMILY PRACTICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-676-9066
Mailing Address - Street 1:230 TEMPLE ST
Mailing Address - Street 2:PO BOX 39
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-1837
Mailing Address - Country:US
Mailing Address - Phone:517-676-9066
Mailing Address - Fax:517-676-3505
Practice Address - Street 1:230 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1837
Practice Address - Country:US
Practice Address - Phone:517-676-9066
Practice Address - Fax:517-676-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301039046207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty