Provider Demographics
NPI:1194769919
Name:JOEBSTL, BARBARA C (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:C
Last Name:JOEBSTL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7133 ROOSEVELT BLVD.
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149
Mailing Address - Country:US
Mailing Address - Phone:215-333-3311
Mailing Address - Fax:215-333-9958
Practice Address - Street 1:7133 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149
Practice Address - Country:US
Practice Address - Phone:215-333-3311
Practice Address - Fax:215-333-9958
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037393E207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012391360005Medicaid
PA651072Medicare PIN
E71716Medicare UPIN