# JEFFERSON UNIVERSITY PHYSICIANS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JUP Multi-Specialty Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619110491
- **Authorized official:** MR. JOHN OGUNKEYE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 955-2562

## Contact information

- **Practice address:** 833 CHESTNUT ST, SUITE 630 JUP CENTRAL ENROLLMENTS, PHILADELPHIA, PA 19107-4414
- **Practice address phone:** (215) 955-0800
- **Mailing address:** 833 CHESTNUT ST, SUITE 630 JUP CENTRAL ENROLLMENTS, PHILADELPHIA, PA 19107-4414
- **Mailing address phone:** (215) 955-0800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2009
- **Last updated:** 04/09/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0060238000 | INDEPENDENCE BLUE CROSSS | PA |