Provider Demographics
NPI:1407732175
Name:FAULKNER, JOSEPH THOMAS
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:THOMAS
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 1:381 BUFFALO LN
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879-4663
Mailing Address - Country:US
Mailing Address - Phone:423-626-0370
Mailing Address - Fax:
Practice Address - Street 1:4101 TATES CREEK CENTRE DR STE 144
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-3068
Practice Address - Country:US
Practice Address - Phone:859-271-2887
Practice Address - Fax:859-271-2889
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist