Provider Demographics
NPI:1033123393
Name:SEPROSKY, JOSEPH CHARLES JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:SEPROSKY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1217 TONWIN ST
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-2338
Mailing Address - Country:US
Mailing Address - Phone:570-614-3970
Mailing Address - Fax:
Practice Address - Street 1:1839 FAIR AVE
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-2121
Practice Address - Country:US
Practice Address - Phone:570-251-6500
Practice Address - Fax:570-253-5697
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042091E207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001229120 0004Medicaid
PA019590200OtherFEDERAL BLACK LUNG
PA0562310OtherAETNA
PA080115661OtherRAILLROAD MEDICARE
PA539622OtherHIGHMARK BLUE SHIELD
PA825258OtherBLUE CROSS OF NE PA / FIRST PRIORITY HEALTH
PA0562310OtherUNITED HEALTHCARE
PA002291200001Medicaid
PA0115756000OtherPA. BLUE SHIELD PERSONAL
PA21278 E4CLOtherGEISINGER HEALTH PLAN
PA21278 E4CLOtherGEISINGER GOLD
PAE55533OtherHEALTH AMERICA
PA539622NUTMedicare PIN
PA001229120 0004Medicaid