Provider Demographics
NPI:1265675953
Name:NEUCKS, JOSHUA S (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:S
Last Name:NEUCKS
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 1:6983 HILLSDALE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2054
Mailing Address - Country:US
Mailing Address - Phone:317-849-8350
Mailing Address - Fax:317-576-6311
Practice Address - Street 1:100 HOSPITAL LN STE 225
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1870
Practice Address - Country:US
Practice Address - Phone:317-718-4730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-11
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072080A2084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201109100Medicaid