Provider Demographics
NPI:1841277712
Name:STRAUSBURG, JOSEPH W (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:STRAUSBURG
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 1:645 E MISSOURI AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1351
Mailing Address - Country:US
Mailing Address - Phone:602-262-8917
Mailing Address - Fax:602-262-8890
Practice Address - Street 1:645 E MISSOURI AVE STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1351
Practice Address - Country:US
Practice Address - Phone:602-262-8917
Practice Address - Fax:602-262-8890
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31473207L00000X
AZ60874207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7706690Medicaid
NE84113438513Medicaid
TX058700801Medicaid
CO01314731Medicaid
WY109404100Medicaid
NML5112Medicaid
CAXPY204631Medicaid
AZ095794Medicaid
KS100166750BMedicaid
MT3506685Medicaid
SD7706690Medicaid
KS100166750BMedicaid
MT3506685Medicaid