MEDICARE: DR. JOHN R JOSEPH M.D.

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	207L00000X	Anesthesiology Physician	9467494-1205	UT
2	207L00000X	Anesthesiology Physician	D0088874	MD
3	207L00000X	Anesthesiology Physician	ME73619	FL

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	:	1497707301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN R JOSEPH M.D.

Provider Business Mailing Address
First Line	:	170 N 1100 E
Second Line	:
City	:	AMERICAN FORK
State	:	UT
Zip	:	84003-2096
Country	:	US
Telephone Number	:	801-855-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	39200 HOOKER HWY
Second Line	:
City	:	BELLE GLADE
State	:	FL
Zip	:	33430-5368
Country	:	US
Telephone Number	:	561-996-6571
Fax Number	:

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	04/03/2020

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