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General NPI Number Information
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NPI Number | 1386852911
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Entity Type | Individual
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Provider Name | JOSEPH GHITIS MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/10/2017
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Provider Practice Location Address
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Address Line | 311 PAGODA OAK
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City | SHAVANO PARK
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State | TX
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Zip | 78230-5619
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Country | US
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Telephone | 804-502-7363
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 950131
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City | LOUISVILLE
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State | KY
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Zip | 40295-0131
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Country | US
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Telephone | 502-804-4766
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Fax | 775-852-6902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME106580
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 49963
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | Q8484
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License Number State | TX
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