Provider Demographics
NPI:1003014762
Name:WHARTON, JOSHUA BLAKE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:BLAKE
Last Name:WHARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 HOMER CLAYTON DR
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2205
Mailing Address - Country:US
Mailing Address - Phone:256-571-8770
Mailing Address - Fax:
Practice Address - Street 1:2307 HOMER CLAYTON DR
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2205
Practice Address - Country:US
Practice Address - Phone:256-571-8770
Practice Address - Fax:256-571-8775
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002457207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology