Provider Demographics
NPI:1235006693
Name:FAULKNER, JOSHUA TIMOTHY
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TIMOTHY
Last Name:FAULKNER
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 1:5406 PYLE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5362
Mailing Address - Country:US
Mailing Address - Phone:740-935-4165
Mailing Address - Fax:
Practice Address - Street 1:445 FRONT ST APT 311
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3855
Practice Address - Country:US
Practice Address - Phone:740-935-4165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant