Healthcare Provider Details

I. General information

NPI: 1720712276
Provider Name (Legal Business Name): JOSEPH NOTHSTINE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 N BALLAS RD STE 380C
SAINT LOUIS MO
63131-2324
US

IV. Provider business mailing address

PO BOX 959354
SAINT LOUIS MO
63195-9354
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-4790
  • Fax: 314-996-4792
Mailing address:
  • Phone: 314-996-4790
  • Fax: 314-996-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number115671
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: