Provider Demographics
NPI:1013909498
Name:JOSEPH, SONIA R (DO)
Entity type:Individual
Prefix:MS
First Name:SONIA
Middle Name:R
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DO
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Other - Last Name:
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Mailing Address - Street 1:225 E JACKSON AVE
Mailing Address - Street 2:MAILSLOT #83
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3119
Mailing Address - Country:US
Mailing Address - Phone:870-207-1630
Mailing Address - Fax:870-207-6581
Practice Address - Street 1:225 E JACKSON AVE
Practice Address - Street 2:MAILSLOT #83
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3119
Practice Address - Country:US
Practice Address - Phone:870-207-1630
Practice Address - Fax:870-207-6581
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY236183207V00000X
ARE7815207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR197351003Medicaid
NY02657683Medicaid
IA0769Medicare ID - Type Unspecified
I32367Medicare UPIN
AR7YRJTMedicare PIN