Provider Demographics
NPI:1699975995
Name:SHARP, JOSHUA DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DOUGLAS
Last Name:SHARP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 N STATE HIGHWAY 47
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-1108
Mailing Address - Country:US
Mailing Address - Phone:636-456-2966
Mailing Address - Fax:636-456-2977
Practice Address - Street 1:704 NORTH STATE HWY 47
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383
Practice Address - Country:US
Practice Address - Phone:636-456-2966
Practice Address - Fax:636-456-2977
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO709172OtherUNITED HEALTH CARE