Provider Demographics
NPI:1851437099
Name:PROSSER, JOSEPH STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:PROSSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ADVENTUS CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8552
Mailing Address - Country:US
Mailing Address - Phone:817-734-9002
Mailing Address - Fax:
Practice Address - Street 1:123 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-6905
Practice Address - Country:US
Practice Address - Phone:817-441-1397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0873207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine