Organization Name: | JOSEPH JOSE MD LLC |
NPI Number: | 1366640989 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH JOSE (PHYSICIAN) |
Mailing Address: | 49 State St Struthers |
State: | OH US |
Postal Code: | 44471 |
Phone Number: | 3307552124 |
Fax Number: | 3307552276 |
NPI Enumeration Date: | 07/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 35090060 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |