Provider Demographics
NPI:1336198241
Name:ANTHONY P JOSEPH MD PA
Entity Type:Organization
Organization Name:ANTHONY P JOSEPH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-753-0000
Mailing Address - Street 1:793 HEALTH CARE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8334
Mailing Address - Country:US
Mailing Address - Phone:386-753-0000
Mailing Address - Fax:386-753-0001
Practice Address - Street 1:793 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8334
Practice Address - Country:US
Practice Address - Phone:386-753-0000
Practice Address - Fax:386-753-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34182OtherBLUECROSS BLUESHEILD
FLDA4007OtherRAILROAD MEDICARE
FL34182OtherBLUECROSS BLUESHEILD
FLG40282Medicare UPIN