Provider Demographics
NPI:1740332048
Name:TEMPLE PHYSICIANS INC.
Entity type:Organization
Organization Name:TEMPLE PHYSICIANS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LEAD CRED SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-926-9019
Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-926-9000
Mailing Address - Fax:215-226-8285
Practice Address - Street 1:9892 BUSTLETON AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-2138
Practice Address - Country:US
Practice Address - Phone:215-676-2741
Practice Address - Fax:215-676-2796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE PHYSICIANS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-17
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01927OtherHEALTH PARTNERS SITE #
PA1961997OtherHIGHMARK BLUE SHIELD
PA5561583OtherAETNA PPO
PA30033849OtherKEYSTONE MERCY
PACD4829OtherRRM
PA100727800Medicaid
PA0000201OtherAETNA HMO
PA0756985039OtherIBC (KHPE & PC)
PA30033849OtherKEYSTONE MERCY