Provider Demographics
NPI:1962841155
Name:JOSHI, BHAVESH (DO)
Entity type:Individual
Prefix:DR
First Name:BHAVESH
Middle Name:
Last Name:JOSHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:STATE UNIVERSITY
Mailing Address - State:AR
Mailing Address - Zip Code:72467-0119
Mailing Address - Country:US
Mailing Address - Phone:860-680-8829
Mailing Address - Fax:
Practice Address - Street 1:560 DEVALL DR STE 201
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-6655
Practice Address - Country:US
Practice Address - Phone:334-887-8707
Practice Address - Fax:334-887-8706
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018106207QS0010X
390200000X
ALDO.2905207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program