Provider Demographics
NPI:1669799144
Name:HASTINGS, JOSHUA LEPRELL (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LEPRELL
Last Name:HASTINGS
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 1:393 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3705
Mailing Address - Country:US
Mailing Address - Phone:803-394-6642
Mailing Address - Fax:
Practice Address - Street 1:895 STATE FARM RD STE 401
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6021
Practice Address - Country:US
Practice Address - Phone:828-264-4691
Practice Address - Fax:828-265-4288
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51336207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1669799144Medicaid
TNQ007175Medicaid