Healthcare Provider Details

I. General information

NPI: 1497915102
Provider Name (Legal Business Name): JOSEPH L. WEBSTER SR. MD. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2048 CENTRE POINTE LN
TALLAHASSEE FL
32308-4300
US

IV. Provider business mailing address

2048 CENTRE POINTE LN
TALLAHASSEE FL
32308-4300
US

V. Phone/Fax

Practice location:
  • Phone: 850-878-0471
  • Fax:
Mailing address:
  • Phone: 850-878-0471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH LEE WEBSTER SR.
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 850-878-0471