Provider Demographics
NPI:1750340733
Name:JOSHI, CHANDRAKANT M
Entity type:Individual
Prefix:
First Name:CHANDRAKANT
Middle Name:M
Last Name:JOSHI
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:CHANDRA
Other - Middle Name:M
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2211 SHED RD
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3637
Mailing Address - Country:US
Mailing Address - Phone:318-746-3880
Mailing Address - Fax:318-746-4288
Practice Address - Street 1:2211 SHED RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3637
Practice Address - Country:US
Practice Address - Phone:318-746-3880
Practice Address - Fax:318-746-4288
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06154R207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology