Provider Demographics
NPI:1982087037
Name:GREENLEAF, JOSHUA R (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:R
Last Name:GREENLEAF
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 1:101 REGENT COURT
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-231-2101
Mailing Address - Fax:800-505-2101
Practice Address - Street 1:3000 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4472
Practice Address - Country:US
Practice Address - Phone:814-231-2101
Practice Address - Fax:814-231-8569
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS018550207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery