Healthcare Provider Details

I. General information

NPI: 1376040956
Provider Name (Legal Business Name): JOSEPH SCOTT WITHROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LAKE CONCORD RD NE
CONCORD NC
28025-2918
US

IV. Provider business mailing address

6400 FANNIN ST STE 2800
HOUSTON TX
77030-1534
US

V. Phone/Fax

Practice location:
  • Phone: 704-792-2672
  • Fax:
Mailing address:
  • Phone: 713-704-7100
  • Fax: 713-704-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2025-00898
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: