Provider Demographics
NPI:1558892844
Name:DAUGHENBAUGH, JOSEPH CADE
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CADE
Last Name:DAUGHENBAUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 LIZ LYNN DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-3962
Mailing Address - Country:US
Mailing Address - Phone:337-309-4681
Mailing Address - Fax:
Practice Address - Street 1:1700 6TH AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-4849
Practice Address - Country:US
Practice Address - Phone:205-434-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program