Provider Demographics
NPI:1891131322
Name:STOUFFLET, JOSHUA JAMES
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:STOUFFLET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 ARENDELL ST
Mailing Address - Street 2:STE J
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2687
Mailing Address - Country:US
Mailing Address - Phone:252-499-2303
Mailing Address - Fax:252-427-1244
Practice Address - Street 1:4915 ARENDELL ST STE J162
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2659
Practice Address - Country:US
Practice Address - Phone:252-499-2303
Practice Address - Fax:252-499-2303
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA085442251X0800X
NCP169502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic