Provider Demographics
NPI:1073263786
Name:BUDD, JOEL T (PA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:T
Last Name:BUDD
Suffix:
Gender:M
Credentials:PA
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:USAG CASEY
Mailing Address - Street 2:BUILDING S0501
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USAG CASEY
Practice Address - Street 2:BUILDING S0501
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96224
Practice Address - Country:US
Practice Address - Phone:315-730-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant