Healthcare Provider Details

I. General information

NPI: 1962118778
Provider Name (Legal Business Name): JOSHUA W ANGLE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5264 COUNCIL ST NE STE 700
CEDAR RAPIDS IA
52402-2477
US

IV. Provider business mailing address

5264 COUNCIL ST NE STE 700
CEDAR RAPIDS IA
52402-2477
US

V. Phone/Fax

Practice location:
  • Phone: 319-363-9936
  • Fax: 319-363-0520
Mailing address:
  • Phone: 319-363-9936
  • Fax: 319-363-0520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: