Provider Demographics
NPI:1750601910
Name:LAGRANT, JOSHUA LEE (DO)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LEE
Last Name:LAGRANT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOSH
Other - Middle Name:
Other - Last Name:LAGRANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:500 W MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-4268
Mailing Address - Country:US
Mailing Address - Phone:808-208-2866
Mailing Address - Fax:
Practice Address - Street 1:500 W MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-4268
Practice Address - Country:US
Practice Address - Phone:808-208-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC821642084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN