Doctor Name: | MR. RICHARD WILLIAM TEMBLADOR |
NPI Number: | 1588638951 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | 102053 |
Business Practice Address: | 25 North Johnson Street Coats, NC - 275210819 |
Business Phone Number: | 9108976423 |
Business Fax Number: | 9108972540 |
Mailing Address: | 25 North Johnson Street, COATS |
State: | NC |
Postal Code: | 275210819 |
Phone Number: | 9108976423 |
Fax Number: | 9106940254 |
NPI Enumeration Date: | 02/14/2006 |
NPI Last Update Date: | 09/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 102053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |