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General NPI Number Information
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NPI Number | 1780874370
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Entity Type | Organization
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Legal Business Name | JOSEPH ORTHOPEDIC SURGERY, P.A.
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 1808 SHERMAN DR STE 2203
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City | PRINCETON
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State | IN
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Zip | 47670-1043
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Country | US
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Telephone | 812-385-1788
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Fax | 812-385-1787
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Provider Business Mailing Address
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Address Line | 1808 SHERMAN DR STE 2203
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City | PRINCETON
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State | IN
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Zip | 47670-1043
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Country | US
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Telephone | 812-385-1788
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Fax | 812-385-1787
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS JOSEPH
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Credential | M.D.
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Telephone | 812-385-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01061734A
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License Number State | IN
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