Organization
TEMPLE PHYSICIANS INC
Active
Parent organization
TEMPLE PHYSICIANS INC
Other names
Temple Physicians Northeastern ENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEMPLE PHYSICIANS INC
Authorized official
RICHARD VAUGHN (LEAD CREDENTIALING SPECIALIST)
(215) 926-9019
Entity
Organization
Contact information
Practice address
2340 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4433
(215) 423-6670
Mailing address
2450 W HUNTING PARK AVE, 2ND FLOOR TPI, PHILADELPHIA, PA 19129-1302
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD017012E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100727800
TPI MEDICAID GROUP
PA
01
—
597586
TPI MEDICARE GROUP
PA
Enumeration date
10/05/2016
Last updated
10/05/2016
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