Provider Demographics
NPI:1235243304
Name:IRWIN, JOSEPH GEORGE (DC, FACO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GEORGE
Last Name:IRWIN
Suffix:
Gender:M
Credentials:DC, FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2427
Mailing Address - Country:US
Mailing Address - Phone:302-798-1587
Mailing Address - Fax:302-798-4441
Practice Address - Street 1:2100 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2427
Practice Address - Country:US
Practice Address - Phone:302-798-1587
Practice Address - Fax:302-798-4441
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000148111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE$$$$$$$$$OtherBLUE CROSS
DE$$$$$$$$$OtherBLUE CROSS
DE068520Medicare PIN