Provider Demographics
NPI:1740578632
Name:HSU, JOSEPH L (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:HSU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 S VAL VISTA DR STE 177
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1683
Mailing Address - Country:US
Mailing Address - Phone:480-394-0200
Mailing Address - Fax:480-394-0202
Practice Address - Street 1:2730 S VAL VISTA DR
Practice Address - Street 2:BLDG. # 13 STE. # 177
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1675
Practice Address - Country:US
Practice Address - Phone:480-394-0200
Practice Address - Fax:480-394-0202
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019139208800000X
AZ006938208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ133996Medicaid
AZ006938OtherAZ STATE LICENSE