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Organization

JEFFERSON UNIVERSITY PHYSICIANS

Active
Other names
Radiology
Organization subpart
No

Provider details

NPI number
Authorized official
VALERIE BRIGHT-BUTLER (ASSOCIATE DIRECTOR)
(215) 955-9457
Entity
Organization

Contact information

Practice address
111 S 11TH ST STE G3390, PHILADELPHIA, PA 19107-4824
(215) 955-2900
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 503-1240

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0562328000
INDEPENDENCE BLUE CROSS
PA
01
2542
AETNA
PA
01
33134
KEYSTONE MERCY
PA
01
656588
HIGHMARK BLUE SHIELD
PA
05
7539002
NJ
Enumeration date
04/18/2008
Last updated
10/14/2022
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