Provider Demographics
NPI:1912907130
Name:PAZ, JOSEPH D (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:PAZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1177 HIGHWAY 315 BLVD
Mailing Address - Street 2:DOLPHIN PLAZA
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6928
Mailing Address - Country:US
Mailing Address - Phone:570-270-5713
Mailing Address - Fax:570-270-5719
Practice Address - Street 1:1177 HIGHWAY 315 BLVD
Practice Address - Street 2:DOLPHIN PLAZA
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6928
Practice Address - Country:US
Practice Address - Phone:570-270-5713
Practice Address - Fax:570-270-5719
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2021-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006388E208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012537990015Medicaid
PA826759OtherFIRST PRIORITY HEALTH
PA8749OtherGEISINGER
PA0012537990015Medicaid
PA550213Medicare PIN