Provider Demographics
NPI:1205816881
Name:PRICE, JOSEPH J JR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:PRICE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1501 LANSDOWNE AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1333
Mailing Address - Country:US
Mailing Address - Phone:610-534-6230
Mailing Address - Fax:610-534-6166
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:STE 201
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:610-534-6230
Practice Address - Fax:610-534-6166
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043660E207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012780900001Medicaid
PA0012780900001Medicaid
F18541Medicare UPIN