Provider Demographics
NPI:1295295640
Name:HERRING, JOSHUA (DO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:HERRING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 99 UNIT 5024
Mailing Address - Street 2:MISAWA AIR BASE
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96319-0068
Mailing Address - Country:US
Mailing Address - Phone:315-226-6133
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 99 UNIT 5024
Practice Address - Street 2:MISAWA AIR BASE
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96319-0068
Practice Address - Country:US
Practice Address - Phone:315-226-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020036789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine