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Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTE L JACKSON (PAYER SUPERVISOR)
(267) 207-7303
Entity
Organization
Contact information
Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-8000
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/21/2024
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