Provider Demographics
NPI:1649277971
Name:GARLAND, JOSEPH L (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:L
Last Name:GARLAND
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:30 MEDPARK SQUARE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503
Mailing Address - Country:US
Mailing Address - Phone:606-677-8360
Mailing Address - Fax:606-677-8399
Practice Address - Street 1:30 MEDPARK SQUARE
Practice Address - Street 2:SUITE 1
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3812
Practice Address - Country:US
Practice Address - Phone:606-677-8360
Practice Address - Fax:606-677-8399
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYPA386363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95000907Medicaid
KY0593903Medicare PIN
KY95000907Medicaid
KY0169Medicare PIN