Provider Demographics
NPI:1710185277
Name:JUSTICE, JOSHUA DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:JUSTICE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:6400 DUTCHMANS PKWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3351
Mailing Address - Country:US
Mailing Address - Phone:502-896-8700
Mailing Address - Fax:502-896-0813
Practice Address - Street 1:6400 DUTCHMANS PKWY
Practice Address - Street 2:SUITE 125
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3351
Practice Address - Country:US
Practice Address - Phone:502-896-8700
Practice Address - Fax:502-896-0813
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2023-02-10
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Provider Licenses
StateLicense IDTaxonomies
KY03386207W00000X
OH34.010533207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100188720Medicaid