Healthcare Provider Details

I. General information

NPI: 1417279076
Provider Name (Legal Business Name): JOSEPH L GLOBOKAR PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 E WATERLOO RD SUITE 313
AKRON OH
44312-3814
US

IV. Provider business mailing address

2215 E WATERLOO RD SUITE 313
AKRON OH
44312-3814
US

V. Phone/Fax

Practice location:
  • Phone: 330-208-2720
  • Fax: 330-208-2721
Mailing address:
  • Phone: 330-208-2720
  • Fax: 330-208-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.000761RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number50.000761
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: