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Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Family Medicine 833 Chestnut
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN OGUNKEYE (EXECUTIVE DIRECTOR)
(215) 955-2562
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST, SUITE 630, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 955-0800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060238001
INDEPENDENCE BLUE CROSS
PA
01
—
148957
HIGHMARK BLUE SHIELD
PA
01
—
45730
KEYSTONE MERCY
PA
01
—
471560
AETNA
PA
05
—
7759908
—
NJ
Enumeration date
04/18/2008
Last updated
04/21/2026
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