Doctor Name: | MR. JOSEPH MICHAEL CARBO |
NPI Number: | 1063436335 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A.-C. |
License Number: | MA002931-L |
Business Practice Address: | 1111 E End Blvd Wilkes Barre, PA - 187110030 |
Business Phone Number: | 5708243521 |
Business Fax Number: | 5708195133 |
Mailing Address: | 115 S Thomas Ave, EDWARDSVILLE |
State: | PA |
Postal Code: | 187044418 |
Phone Number: | 5703312931 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | MA002931-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |