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General NPI Number Information
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NPI Number | 1831650779
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Entity Type | Individual
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Provider Name | JOSHUA PROFFITT MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 124 NOLAND DR
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City | MOORESBURG
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State | TN
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Zip | 37811-4400
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Country | US
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Telephone | 423-500-5336
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Fax | 423-500-5339
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Provider Business Mailing Address
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Address Line | 124 NOLAND DR
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City | MOORESBURG
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State | TN
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Zip | 37811-4400
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Country | US
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Telephone | 423-500-5336
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Fax | 423-500-5339
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TP451
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 67919
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | TP451
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License Number State | KY
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