Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | C1-0008348 | DE |
NPI | 1063547511 |
---|---|
Provider Name | Dr. Joseph James Straight |
First Address | Newark, DE 19702-3358 |
Second Address | Newark, DE 19713-2067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 05/10/2018 |