Provider Demographics
NPI:1851347066
Name:OVERBY, JOSEPH RANDAL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RANDAL
Last Name:OVERBY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 12248
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2248
Mailing Address - Country:US
Mailing Address - Phone:252-633-1678
Mailing Address - Fax:252-633-1403
Practice Address - Street 1:1040 MEDICAL PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5248
Practice Address - Country:US
Practice Address - Phone:252-633-1678
Practice Address - Fax:252-633-1403
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC17408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC64406OtherBCBS OF NC
NC8964406Medicaid
NC209352AMedicare PIN
NC080114253Medicare PIN
NC64406OtherBCBS OF NC
NC209352BMedicare PIN