Provider Demographics
NPI:1386215135
Name:CAROTHERS, JOSEPH M
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:CAROTHERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CTY RD 8
Mailing Address - Street 2:
Mailing Address - City:DILLONVALE
Mailing Address - State:OH
Mailing Address - Zip Code:43917
Mailing Address - Country:US
Mailing Address - Phone:937-206-9080
Mailing Address - Fax:
Practice Address - Street 1:32 CTY RD 8
Practice Address - Street 2:
Practice Address - City:DILLONVALE
Practice Address - State:OH
Practice Address - Zip Code:43917
Practice Address - Country:US
Practice Address - Phone:937-206-9080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist