Healthcare Provider Details

I. General information

NPI: 1902460603
Provider Name (Legal Business Name): MR. JOSEPH HWANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2019
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 HIGHWAY 31 NW
HARTSELLE AL
35640-4464
US

IV. Provider business mailing address

1199 HIGHWAY 31 NW STE F
HARTSELLE AL
35640-4469
US

V. Phone/Fax

Practice location:
  • Phone: 256-965-3010
  • Fax: 256-965-3021
Mailing address:
  • Phone: 256-965-3010
  • Fax: 256-965-3021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2426
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9803
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: