Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 35033066 | OH |
NPI | 1184790586 |
---|---|
Provider Name | Dr. John S Temponeras |
First Address | Portsmouth, OH 45662 |
Second Address | Portsmouth, OH 45662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0164138 | (05) | OH |
612742 | WORKERS COMP (01) | |
A73593 | (02) | OH |