Provider Demographics
NPI:1518233147
Name:PIERPONT, JOSHUA JONATHON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:JONATHON
Last Name:PIERPONT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FORT BRAGG
Mailing Address - Street 2:82ND AIRBORNE DIVISION
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:78210
Mailing Address - Country:US
Mailing Address - Phone:907-306-9670
Mailing Address - Fax:
Practice Address - Street 1:FORT BRAGG
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:78210
Practice Address - Country:US
Practice Address - Phone:907-306-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant