Provider Demographics
NPI:1750645560
Name:HIMES, JOEL DOUGLAS (DO)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:DOUGLAS
Last Name:HIMES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-371-2200
Mailing Address - Fax:
Practice Address - Street 1:145 HOSPITAL AVE STE 311
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1465
Practice Address - Country:US
Practice Address - Phone:814-375-6200
Practice Address - Fax:814-375-6452
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS017442207P00000X, 207PS0010X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program