Provider Demographics
NPI:1164486031
Name:JOSHI, ATUL B (MD)
Entity Type:Individual
Prefix:
First Name:ATUL
Middle Name:B
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2215 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1105
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:3506 21ST ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79714
Practice Address - Country:US
Practice Address - Phone:806-725-4818
Practice Address - Fax:806-723-7021
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0835207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160775602Medicaid
TX8C1432Medicare PIN
TX160775602Medicaid