Provider Demographics
NPI:1144222829
Name:ESKONEN, JOSHUA J (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:J
Last Name:ESKONEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1557
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-0557
Mailing Address - Country:US
Mailing Address - Phone:765-349-6779
Mailing Address - Fax:765-349-8413
Practice Address - Street 1:1949 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-1861
Practice Address - Country:US
Practice Address - Phone:765-349-6779
Practice Address - Fax:765-349-8413
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002967A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200525010Medicaid
IN1033110564OtherGROUP NPI NUMBER
IN200092590Medicaid
IN563420Medicare ID - Type UnspecifiedM-CARE GROUP NUMBER
IN563420UMedicare PIN