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Organization
TEMPLE FACULTY PRACTICE PLAN INC
Active
Organization
TEMPLE FACULTY PRACTICE PLAN INC
Active
Other names
Temple Faculty MIC Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA WOODARD (DIRECTOR REVENUE CYCLE)
(215) 707-3911
Entity
Organization
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-1622
(215) 707-0943
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-1622
(215) 707-0943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
—
—
Other
Enumeration date
09/06/2018
Last updated
05/29/2025
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