Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 58460 | AZ |
NPI | 1124361373 |
---|---|
Provider Name | Dr. Joshua William Hustedt |
First Address | Phoenix, AZ 85006-2511 |
Second Address | Phoenix, AZ 85006-2506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2013 |
Last Update Date | 22/12/2021 |