Provider Demographics
NPI:1801837646
Name:JOSEPH, JAMES JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:JOSEPH
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:10100 E SHANNON WOODS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4104
Mailing Address - Country:US
Mailing Address - Phone:316-219-8299
Mailing Address - Fax:316-219-5899
Practice Address - Street 1:10100 E SHANNON WOODS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4104
Practice Address - Country:US
Practice Address - Phone:316-219-8299
Practice Address - Fax:316-219-5899
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2017-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-21150207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1260OtherPREFERRED HEALTH SYSTEMS
KS102518OtherBLUE SHIELD
KS100115260DMedicaid
200045359OtherRR MEDICARE
KS102518OtherBLUE SHIELD
E36704Medicare UPIN