Provider Demographics
NPI:1487866471
Name:ALDRICH, JOSEPH ALBERT III (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:ALDRICH
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:7950 MARTIN LOOP
Mailing Address - Street 2:MACH DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905-5648
Mailing Address - Country:US
Mailing Address - Phone:706-544-3102
Mailing Address - Fax:
Practice Address - Street 1:7950 MARTIN LOOP
Practice Address - Street 2:MACH DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5648
Practice Address - Country:US
Practice Address - Phone:706-544-3102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2011-11-03
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Provider Licenses
StateLicense IDTaxonomies
MI5101017021207P00000X
MO2009030095207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO132130022Medicare PIN