=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902549991
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA ALLEN MOUNT NP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2022
-----------------------------------------------------
Last Update Date | 03/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 118 OBRANNAN PARK DR
-----------------------------------------------------
City | DOTHAN
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36303-2052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-305-2800
-----------------------------------------------------
Fax | 866-554-1248
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 118 OBRANNAN PARK DR
-----------------------------------------------------
City | DOTHAN
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36303-2052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-305-2800
-----------------------------------------------------
Fax | 866-554-1248
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1-138551
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------