1396749875 NPI number — DR. JOSHUA M FINK D.C., B.S.

Table of content: DR. JOSHUA M FINK D.C., B.S. (NPI 1396749875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396749875 NPI number — DR. JOSHUA M FINK D.C., B.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINK
Provider First Name:
JOSHUA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C., B.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396749875
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1755 STUMP RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DARDENNE PRAIRIE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63368-6716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-922-0777
Provider Business Mailing Address Fax Number:
636-922-0833

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1755 STUMP RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DARDENNE PRAIRIE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63368-6716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-922-0777
Provider Business Practice Location Address Fax Number:
636-922-0833
Provider Enumeration Date:
06/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2002001434 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 170328 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 513802 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 861060218 . This is a "MUTUAL OF OMAHA COMPANIES" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 861060218 . This is a "HUMANA, INC." identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 861060218 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 3713696 . This is a "CARPENTERS HEALTH & WELFARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: DB1222 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 568329 . This is a "COVENTRY HEALTH & LIFE INSURANCE COMPANY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 86-1060218 003 . This is a "WELFARD EDUCATIONAL FUND" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 861060218 . This is a "CMR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 861060218 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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