Provider Demographics
NPI:1437285103
Name:JOSEPH G ABDO MD PC
Entity Type:Organization
Organization Name:JOSEPH G ABDO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:ABDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-425-7133
Mailing Address - Street 1:PO BOX 1040
Mailing Address - Street 2:
Mailing Address - City:GLOBE
Mailing Address - State:AZ
Mailing Address - Zip Code:85502-1040
Mailing Address - Country:US
Mailing Address - Phone:928-425-7133
Mailing Address - Fax:928-425-7134
Practice Address - Street 1:1100 E MONROE ST
Practice Address - Street 2:STE 102
Practice Address - City:GLOBE
Practice Address - State:AZ
Practice Address - Zip Code:85501-1363
Practice Address - Country:US
Practice Address - Phone:928-425-7133
Practice Address - Fax:928-425-7134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ81324Medicare PIN