Organization
TEMPLE FACULTY PRACTICE PLAN INC
Active
Parent organization
TEMPLE FACULTY PRACTICE PLAN INC
Other names
Temple Faculty Family Medicine Peds Associates (LEHB)
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEMPLE FACULTY PRACTICE PLAN INC
Authorized official
RICHARD VAUGHN (CREDENTIALING SPECIALIST)
(215) 926-9019
Entity
Organization
Contact information
Practice address
9433 ROOSEVELT BOULEVARD, PHILADELPHIA, PA 19114
(215) 707-2400
(215) 707-4034
Mailing address
3500 N BROAD ST RM 1A, PHILADELPHIA, PA 19140-4106
(215) 926-9019
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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