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NPI Code Detail

MEDICARE: JOSEPH EDWARD HANDLEY PA-C

MEDICARE: JOSEPH EDWARD HANDLEY PA-C
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
1363A00000XPhysician Assistant7621GA
2363A00000XPhysician AssistantPA214134OR

General Provider Information

NPI Number : 1720462039
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH EDWARD HANDLEY PA-C
Provider Business Mailing Address
First Line : PO BOX 1189
Second Line :
City : CORVALLIS
State : OR
Zip : 97339-1189
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 920 SW RANGE DR
Second Line :
City : WALDPORT
State : OR
Zip : 97394-9634
Country : US
Telephone Number : 541-563-3197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2015
Last Update Date : 06/20/2023

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Directions to “ JOSEPH EDWARD HANDLEY PA-C” Practice Location

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