Healthcare Provider Details

I. General information

NPI: 1205301280
Provider Name (Legal Business Name): JOSHUA MILES MACNAUGHTON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S GLENBURNIE RD STE 210
NEW BERN NC
28562-5227
US

IV. Provider business mailing address

1529 PERSIMMON RDG
LOUDON TN
37774-4713
US

V. Phone/Fax

Practice location:
  • Phone: 252-302-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16727
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number298552
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP056429T
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: