Provider Demographics
NPI:1881893139
Name:JOSEPH, BINITHA (MD)
Entity type:Individual
Prefix:DR
First Name:BINITHA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-3034
Mailing Address - Country:US
Mailing Address - Phone:318-335-4449
Mailing Address - Fax:318-335-4447
Practice Address - Street 1:107 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-3034
Practice Address - Country:US
Practice Address - Phone:318-335-4449
Practice Address - Fax:318-335-3831
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202163207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1188468Medicaid
LA4N2627460Medicare PIN
P00633224Medicare PIN