Provider Demographics
NPI:1225072556
Name:JOSLIN, EDDIE RAY (MD)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:RAY
Last Name:JOSLIN
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 1:2460 N IH 35 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5266
Mailing Address - Country:US
Mailing Address - Phone:469-800-9500
Mailing Address - Fax:469-800-9510
Practice Address - Street 1:2460 N IH 35 E
Practice Address - Street 2:SUITE 100
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5266
Practice Address - Country:US
Practice Address - Phone:469-800-9500
Practice Address - Fax:469-800-9510
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BR070OtherBCBS
TX1153207-04Medicaid
TX115320705Medicaid
TX84Y713OtherBCBS
TXF18813Medicare UPIN
TX115320705Medicaid
TX1153207-04Medicaid
TX8F3668Medicare PIN
TX84Y713OtherBCBS