Provider Demographics
NPI:1215971247
Name:JOSEPHS, JOHN D (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:JOSEPHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4001 W 15TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5841
Mailing Address - Country:US
Mailing Address - Phone:972-608-2025
Mailing Address - Fax:972-608-2032
Practice Address - Street 1:6513 PRESTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2688
Practice Address - Country:US
Practice Address - Phone:972-608-2025
Practice Address - Fax:972-608-2032
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0031174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044156004Medicaid
TX044156004Medicaid