Provider Demographics
NPI:1558355941
Name:JOSEPH, JOJU MATHEWS (MD)
Entity Type:Individual
Prefix:
First Name:JOJU
Middle Name:MATHEWS
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:270 EAST MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066
Practice Address - Country:US
Practice Address - Phone:615-452-3250
Practice Address - Fax:615-452-5186
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43872207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510655Medicaid
TNH48329Medicare UPIN
TN3002519Medicare PIN
OH2469092Medicaid
TN30025191Medicare PIN
KYH48329Medicare UPIN