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General NPI Number Information
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NPI Number | 1508841032
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Entity Type | Individual
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Provider Name | JOSEPH ANTHONY DESTEFANO JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 800 N JUSTICE ST
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3410
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Country | US
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Telephone | 828-694-7687
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Fax | 828-694-5763
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Provider Business Mailing Address
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Address Line | 432 ARROWHEAD DR 3RD FLOOR
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City | KINGSPORT
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State | TN
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Zip | 37664-5291
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Country | US
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Telephone | 423-557-2231
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38537
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 17274
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101251249
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 38537
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2003-00332
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License Number State | NC
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