Provider Demographics
NPI:1922140409
Name:CALHOUN, JOSHUA WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WESLEY
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:239 WESTGATE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4709
Mailing Address - Country:US
Mailing Address - Phone:314-726-4564
Mailing Address - Fax:
Practice Address - Street 1:5647 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2615
Practice Address - Country:US
Practice Address - Phone:314-531-1770
Practice Address - Fax:314-381-6796
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6G722084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB77130Medicare UPIN