Provider Demographics
NPI:1972026250
Name:DRISKILL, JOSEPH ALLEN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALLEN
Last Name:DRISKILL
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 1:137 RHONDA RD
Mailing Address - Street 2:
Mailing Address - City:RUSTBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24588-3765
Mailing Address - Country:US
Mailing Address - Phone:434-316-2354
Mailing Address - Fax:434-332-3989
Practice Address - Street 1:137 RHONDA RD.
Practice Address - Street 2:
Practice Address - City:RUSTBURG
Practice Address - State:VA
Practice Address - Zip Code:24588
Practice Address - Country:US
Practice Address - Phone:434-316-2354
Practice Address - Fax:434-332-3989
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAC24658496172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver