MEDICARE: EDDIE RAY JOSLIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	J0032	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8BR070	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	84Y713	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1225072556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDIE RAY JOSLIN M.D.

Provider Business Mailing Address
First Line	:	2460 N IH 35 E
Second Line	:	SUITE 100
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5266
Country	:	US
Telephone Number	:	469-800-9500
Fax Number	:	469-800-9510

Provider Business Practice Location Address
First Line	:	2460 N IH 35 E
Second Line	:	SUITE 100
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5266
Country	:	US
Telephone Number	:	469-800-9500
Fax Number	:	469-800-9510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	09/14/2015

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