Provider Demographics
NPI:1992804587
Name:WARREN, JOSEPH RAY JR (PA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RAY
Last Name:WARREN
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:715 ANTIOCH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-7177
Mailing Address - Country:US
Mailing Address - Phone:919-345-3692
Mailing Address - Fax:
Practice Address - Street 1:109 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NC
Practice Address - Zip Code:27830-8710
Practice Address - Country:US
Practice Address - Phone:919-242-4382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001000431363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical