Provider Demographics
NPI:1164452587
Name:SEMPLE, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SEMPLE
Suffix:
Gender:M
Credentials:MD
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 1590
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06506-1590
Mailing Address - Country:US
Mailing Address - Phone:203-397-8000
Mailing Address - Fax:203-389-1540
Practice Address - Street 1:28 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3654
Practice Address - Country:US
Practice Address - Phone:860-344-6174
Practice Address - Fax:860-344-6062
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037355207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500HBL066CT01OtherBC/BS#
CT0004384150OtherAETNA/US HEALTHCARE#
CT1758559OtherCIGNA HEALTHCARE#
CT001373555P1OtherBLUE CARE FAMILY PLAN#
CT4832OtherCONNECTICARE#
CT001373555P1OtherBLUE CARE FAMILY PLAN#