Provider Demographics
NPI:1518062728
Name:ACCURSO, JOESPH WALTER III (DC)
Entity Type:Individual
Prefix:DR
First Name:JOESPH
Middle Name:WALTER
Last Name:ACCURSO
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 THEATRE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3131
Mailing Address - Country:US
Mailing Address - Phone:904-222-6440
Mailing Address - Fax:904-222-6450
Practice Address - Street 1:84 THEATRE DR STE 500
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3131
Practice Address - Country:US
Practice Address - Phone:904-222-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381682600Medicaid
FLU95519Medicare UPIN
FL381682600Medicaid