Provider Demographics
NPI:1700867850
Name:FOSTER, JOSEPH PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:FOSTER
Suffix:
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 1:28150 N MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526
Mailing Address - Country:US
Mailing Address - Phone:251-621-9010
Mailing Address - Fax:251-621-9011
Practice Address - Street 1:28150 N MAIN ST
Practice Address - Street 2:STE A
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526
Practice Address - Country:US
Practice Address - Phone:251-621-9010
Practice Address - Fax:251-621-9011
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51503625OtherBCBS AL
AL5042245OtherAETNA
AL5042245OtherAETNA