Provider Demographics
NPI:1497454268
Name:TRAMMELL, JOSHUA WILLIAM (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:WILLIAM
Last Name:TRAMMELL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:1000 E PRIMROSE ST STE 170
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5192
Practice Address - Country:US
Practice Address - Phone:417-269-6000
Practice Address - Fax:417-269-9853
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023007818363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant