Provider Demographics
NPI:1740366442
Name:TEMPLES, PAMELA H (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:H
Last Name:TEMPLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 NORTHWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1398
Mailing Address - Country:US
Mailing Address - Phone:229-262-6810
Mailing Address - Fax:229-219-1634
Practice Address - Street 1:814 NORTHWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1398
Practice Address - Country:US
Practice Address - Phone:229-262-6810
Practice Address - Fax:229-219-1634
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053045207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA651676419AMedicaid
GAGRP836Medicare ID - Type Unspecified