Provider Demographics
NPI:1780065151
Name:JOEL R TEMPLE MD
Entity type:Organization
Organization Name:JOEL R TEMPLE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-678-1343
Mailing Address - Street 1:9 E LOOCKERMAN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-8305
Mailing Address - Country:US
Mailing Address - Phone:302-678-1343
Mailing Address - Fax:302-678-1344
Practice Address - Street 1:9 E LOOCKERMAN ST STE 303
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-8305
Practice Address - Country:US
Practice Address - Phone:302-678-1343
Practice Address - Fax:302-678-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0000597207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE207KA0200XMedicaid
DE207KA0200XMedicaid