Provider Demographics
NPI:1629010830
Name:TOBIN, JOSHUA A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:A
Last Name:TOBIN
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:PO BOX 15567
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-5567
Mailing Address - Country:US
Mailing Address - Phone:602-265-6500
Mailing Address - Fax:
Practice Address - Street 1:2601 N 3RD ST
Practice Address - Street 2:SUITE 125
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1104
Practice Address - Country:US
Practice Address - Phone:602-265-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ306242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ355489Medicaid
AZ355489Medicaid