Provider Demographics
NPI:1023219987
Name:AZAR, JOSEPH K (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:K
Last Name:AZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:KHALIL
Other - Last Name:AZAR
Other - Suffix:II
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:703 RIVERWAY PL
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6768
Mailing Address - Country:US
Mailing Address - Phone:603-627-1661
Mailing Address - Fax:603-669-6944
Practice Address - Street 1:703 RIVERWAY PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6745
Practice Address - Country:US
Practice Address - Phone:603-627-1661
Practice Address - Fax:603-669-6944
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD600877962085B0100X, 2085R0202X
ORMD281182085R0202X
NH238612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0423970OtherL&I-RADIA-REST OF WA
OR218640Medicaid
WA0423975OtherL&I-SOUTH SOUND RADIOLOGY
WA0423972OtherL&I-SWEDISH RADIA EDMONDS
WA0423971OtherL&I-RADIA-KING
WA0423974OtherL&I-EVERGREEN RADIA
WA0423976OtherL&I-SEATTLE RADIOLOGY
WA1088366Medicaid