Basic Information
Provider Information
NPI: 1518250331
EntityType: 2
ReplacementNPI:  
OrganizationName: TEMPLE UNIVERSITY HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 3401 N BROAD ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191405103
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3401 N BROAD ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191405103
CountryCode: US
TelephoneNumber: 2157073397
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2011
LastUpdateDate: 05/26/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: PIRKLE
AuthorizedOfficialFirstName: CHRISTEN
AuthorizedOfficialMiddleName: SUZANNE
AuthorizedOfficialTitleorPosition: RESIDENT PHYSICIAN
AuthorizedOfficialTelephone: 4046428771
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000XMT199285PAY HospitalsGeneral Acute Care Hospital 

No ID Information.


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