Basic Information
| Provider Information | |||||||||
| NPI: | 1013069194 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TEMPLE PHYSICIANS INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | TPI INTERNAL MEDICINE LEHIGH | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 820933 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159269010 | ||||||||
| FaxNumber: | 2152268285 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E LEHIGH AVE | ||||||||
| Address2: | CHC - 1 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191251012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157071866 | ||||||||
| FaxNumber: | 2157071876 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 02/01/2008 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SAVERING | ||||||||
| AuthorizedOfficialFirstName: | LYNNIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2159269015 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | TEMPLE PHYSICIANS INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0756985055 | 01 | PA | IBC (KHPE & PC) | OTHER | 0465540 | 01 | PA | AETNA HMO | OTHER | 15337 | 01 | PA | ELDER HEALTH | OTHER | 5033499 | 01 | PA | AETNA PPO | OTHER | 02846 | 01 | PA | HEALTH PARTNERS SITE # | OTHER | 100727800 | 05 | PA | MEDICAID | 30011043 | 01 | PA | KEYSTONE MERCY | OTHER | 3055552 | 01 | PA | CIGNA CAP & PPO | OTHER | 1961990 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | CD4829 | 01 | PA | RRM | OTHER |