Healthcare Provider Details

I. General information

NPI: 1649277971
Provider Name (Legal Business Name): JOSEPH L GARLAND PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEDPARK SQUARE SUITE 1
SOMERSET KY
42503-3812
US

IV. Provider business mailing address

30 MEDPARK SQUARE SUITE 1
SOMERSET KY
42503
US

V. Phone/Fax

Practice location:
  • Phone: 606-677-8360
  • Fax: 606-677-8399
Mailing address:
  • Phone: 606-677-8360
  • Fax: 606-677-8399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA386
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: