MEDICARE: JOSHUA ANDREW FIFE DO

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	208000000X	Pediatrics Physician	5522	GA
2	208000000X	Pediatrics Physician	02005070A	IN

General Provider Information

NPI Number	:	1609130558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA ANDREW FIFE DO

Provider Business Mailing Address
First Line	:	151 N GARDENMILE RD
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-5543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 N GARDENMILE RD
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-5543
Country	:	US
Telephone Number	:	270-830-9186
Fax Number	:

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

Provider Enumeration Date	:	06/26/2012
Last Update Date	:	06/21/2022

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