Provider Demographics
NPI:1134713852
Name:RECCORD, JOSEPH LOUIS
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LOUIS
Last Name:RECCORD
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 1:33001 SOLON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2864
Mailing Address - Country:US
Mailing Address - Phone:216-355-5667
Mailing Address - Fax:
Practice Address - Street 1:33001 SOLON RD STE 202
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2864
Practice Address - Country:US
Practice Address - Phone:216-355-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36D2187813207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine