Provider Demographics
NPI:1801506894
Name:HILD, JOSHUA TYLER (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TYLER
Last Name:HILD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 OLD FORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1865
Mailing Address - Country:US
Mailing Address - Phone:502-797-4202
Mailing Address - Fax:
Practice Address - Street 1:1255 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1495
Practice Address - Country:US
Practice Address - Phone:812-414-2273
Practice Address - Fax:812-414-2365
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003343A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor