Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Radiation Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN PADGETT (CREDENTIALING MANAGER)
(215) 955-1175
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST STE 630, PHILADELPHIA, PA 19107-4416
(215) 955-0800
Mailing address
833 CHESTNUT ST, SUITE 630, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0296523000
INDEPENDENCE BLUE CROSS
PA
01
—
160070
HIGHMARK BLUE SHIELD
PA
01
—
33136
KEYSTONE MERCY
PA
01
—
500450
AETNA
PA
05
—
7503008
—
NJ
Enumeration date
04/18/2008
Last updated
06/13/2024
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