Individual
MR. THADDEUS ROLAND TEMPLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 N BROAD ST, NEW ORLEANS, LA 70119-3302
(504) 482-9755
(504) 482-9844
Mailing address
1221 N BROAD ST, NEW ORLEANS, LA 70119-3302
(504) 482-9755
(504) 482-9844
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017362
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346659
—
LA
01
—
4689446990
BLUE CROSS
LA
Enumeration date
05/03/2006
Last updated
07/08/2007
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