Provider Demographics
NPI:1376762047
Name:FAUST, JOSEPH FENTON (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FENTON
Last Name:FAUST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7205 BONNEVAL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7565
Mailing Address - Country:US
Mailing Address - Phone:904-296-0098
Mailing Address - Fax:904-861-3899
Practice Address - Street 1:125 EXECUTIVE DR
Practice Address - Street 2:STE E
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4155
Practice Address - Country:US
Practice Address - Phone:434-385-5600
Practice Address - Fax:434-455-7172
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2018-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME78643207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology