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General NPI Number Information
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NPI Number | 1598405706
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Entity Type | Individual
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Provider Name | JOEL JAVIER CARDONA DPM
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Gender | Male
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1068 CRESTHAVEN RD STE 110
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City | MEMPHIS
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State | TN
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Zip | 38119-0845
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Country | US
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Telephone | 901-767-5620
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Fax | 901-763-4326
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Provider Business Mailing Address
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Address Line | 1068 CRESTHAVEN RD STE 300
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City | MEMPHIS
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State | TN
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Zip | 38119-0809
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Country | US
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Telephone | 901-866-8864
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 978
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License Number State | TN
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