Provider Demographics
NPI:1417029398
Name:WALDEN, JOSEPH JUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JUDE
Last Name:WALDEN
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-7134
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:840 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7444
Practice Address - Country:US
Practice Address - Phone:717-272-2700
Practice Address - Fax:717-272-2757
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102279747 0002Medicaid
PA089047Medicare ID - Type Unspecified
PAG86566Medicare UPIN