MEDICARE: MICHAEL D JOSEPHS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	L4478	TX
2	2086S0120X	Pediatric Surgery Physician	L4478	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083606289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D JOSEPHS MD

Provider Business Mailing Address
First Line	:	1301 BARBARA JORDAN BLVD
Second Line	:	SUITE 400
City	:	AUSTIN
State	:	TX
Zip	:	78723-3078
Country	:	US
Telephone Number	:	512-708-1234
Fax Number	:	512-708-4567

Provider Business Practice Location Address
First Line	:	1301 BARBARA JORDAN BLVD
Second Line	:	SUITE 400
City	:	AUSTIN
State	:	TX
Zip	:	78723-3078
Country	:	US
Telephone Number	:	512-708-1234
Fax Number	:	512-708-4567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	02/02/2012

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