Basic Information
| Provider Information | |||||||||
| NPI: | 1417407768 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HR PHYSICIAN SERVICES | ||||||||
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| OtherOrganizationName: | TEMPLE NEUROSURGEONS AT HOLY REDEEMER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12265 TOWNSEND RD | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191541201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158561010 | ||||||||
| FaxNumber: | 2156983730 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 HUNTINGDON PIKE | ||||||||
| Address2: | SUITE 154 | ||||||||
| City: | MEADOWBROOK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190468004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159381661 | ||||||||
| FaxNumber: | 2159383144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2016 | ||||||||
| LastUpdateDate: | 10/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | WAGNER | ||||||||
| AuthorizedOfficialFirstName: | RUSSELL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESIDENT, FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 2158561114 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.