Provider Demographics
NPI:1245269778
Name:UNDERHILL, JOSHUA J (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:J
Last Name:UNDERHILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0485
Mailing Address - Country:US
Mailing Address - Phone:765-521-1516
Mailing Address - Fax:765-599-3131
Practice Address - Street 1:152 WITTENBRAKER AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-5000
Practice Address - Country:US
Practice Address - Phone:765-599-3100
Practice Address - Fax:765-518-5365
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01069630A208000000X
IL036-099663208000000X
MI4301076217208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201021230Medicaid
IN201021230Medicaid