Provider Demographics
NPI:1184629602
Name:JOSEPH, HAL (C-RPA)
Entity Type:Individual
Prefix:MR
First Name:HAL
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:C-RPA
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 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:1775 AURORA CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2536
Practice Address - Country:US
Practice Address - Phone:303-724-2323
Practice Address - Fax:303-724-6797
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA472363A00000X
COPA.0000903363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805232400Medicaid
IDR54969OtherUPIN #
ID805232400Medicaid