Provider Demographics
NPI:1285480384
Name:CALDWELL, JOSHUA ALLEN
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALLEN
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 SPRINGMILL ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-1105
Mailing Address - Country:US
Mailing Address - Phone:561-274-2748
Mailing Address - Fax:
Practice Address - Street 1:617 SPRINGMILL ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-1105
Practice Address - Country:US
Practice Address - Phone:561-274-2748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSW466315207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services