Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | L019073 | LA |
N | 207YS0123X | Facial Plastic Surgeon | L019073 | LA |
NPI | 1336132315 |
---|---|
Provider Name | Dr. Jeffrey J Joseph |
First Address | Lafayette, LA 70503-2464 |
Second Address | Lafayette, LA 70503-2464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 16/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040017313 | RAILROAD MEDICARE (01) | LA |
1443727 | (05) | LA |
F55777 | (02) |