Doctor Name: | DR. JAY KAUSHIK JOSHI |
NPI Number: | 1497047435 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., M.B.A. |
License Number: | 01074818A |
Business Practice Address: | 2640 Hamstrom Rd Portage, IN - 463683832 |
Business Phone Number: | 6304308024 |
Business Fax Number: | |
Mailing Address: | 2640 Hamstrom Rd, PORTAGE |
State: | IN |
Postal Code: | 463683832 |
Phone Number: | 6304308024 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2011 |
NPI Last Update Date: | 12/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01074818A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |