Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Otolaryngology
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
833 CHESTNUT ST, SUITE 630, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020893
HIGHMARK BLUE SHIELD
PA
01
—
0445474000
INDEPENDENCE BLUE CROSS
PA
01
—
1153900
KEYSTONE MERCY
PA
05
—
7491301
—
NJ
01
—
955095
AETNA
PA
Enumeration date
04/18/2008
Last updated
04/24/2008
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