Healthcare Provider Details

I. General information

NPI: 1568576551
Provider Name (Legal Business Name): ANTONY JOSEPH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7135 JAHNKE RD
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

P.O. BOX 35691
RICHMOND VA
23235
US

V. Phone/Fax

Practice location:
  • Phone: 804-330-8106
  • Fax: 804-330-2938
Mailing address:
  • Phone: 804-330-8106
  • Fax: 804-330-2938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101030069
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: