Basic Information
| Provider Information | |||||||||
| NPI: | 1801970322 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TEMPLETON | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 892 | ||||||||
| Address2: | |||||||||
| City: | CONCORDVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193310892 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103724957 | ||||||||
| FaxNumber: | 6103723117 | ||||||||
| Practice Location | |||||||||
| Address1: | 484 W. STATE STREET | ||||||||
| Address2: | |||||||||
| City: | DOYLESTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189012554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153452290 | ||||||||
| FaxNumber: | 2153452596 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 04/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 013505 | ME | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 309250099 | 05 | ME | MEDICAID | F54087 | 01 | ME | HPHC | OTHER | 0005709031 | 01 | ME | AETNA/USHC | OTHER | M83153 | 01 | ME | CIGNA | OTHER | 024278 | 01 | ME | ANTHEM | OTHER | 102521592-0002 | 05 | PA | MEDICAID | 2323447 | 01 | ME | AETNA | OTHER | P00897057 | 01 | PA | RR MEDICARE | OTHER |