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General NPI Number Information
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NPI Number | 1770753311
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Entity Type | Organization
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Legal Business Name | GEORGE M JOSEPH MD PA
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 2370 3RD ST S SUITE 1
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4023
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Country | US
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Telephone | 904-280-3552
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Fax | 904-280-3571
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Provider Business Mailing Address
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Address Line | 2370 3RD ST S SUITE 1
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4023
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Country | US
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Telephone | 904-280-3552
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Fax | 904-280-3571
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE M. JOSEPH
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Credential | M.D.
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Telephone | 904-280-3552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME 15175
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License Number State | FL
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