Provider Demographics
NPI:1164181475
Name:JOINER, PRESTON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:
Last Name:JOINER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 ARCLAIR PL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5610
Mailing Address - Country:US
Mailing Address - Phone:989-860-0791
Mailing Address - Fax:
Practice Address - Street 1:1146 ARCLAIR PL
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5610
Practice Address - Country:US
Practice Address - Phone:989-860-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601010845363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant