Healthcare Provider Details

I. General information

NPI: 1235243304
Provider Name (Legal Business Name): JOSEPH GEORGE IRWIN DC, FACO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PHILADELPHIA PIKE
CLAYMONT DE
19703-2427
US

IV. Provider business mailing address

2100 PHILADELPHIA PIKE
CLAYMONT DE
19703-2427
US

V. Phone/Fax

Practice location:
  • Phone: 302-798-1587
  • Fax: 302-798-4441
Mailing address:
  • Phone: 302-798-1587
  • Fax: 302-798-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberF1-0000148
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: