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Organization

JEFFERSON UNIVERSITY PHYSICIANS

Active
Other names
Nephrology
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
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0308957000
INDEPENDENCE BLUE CROSS
PA
01
0508554000
AMERIHEALTH
PA
01
1004652
KEYSTONE MERCY
PA
01
2687974
AETNA NJ
NJ
01
435680
HIGHMARK BLUE SHIELD
PA
01
460938
AETNA
PA
05
7428308
NJ
Enumeration date
04/18/2008
Last updated
04/24/2008
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