1225068331 NPI number — DR. JOSEPH H SATURLEY PH.D.

Table of content: DR. JOSEPH H SATURLEY PH.D. (NPI 1225068331)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225068331 NPI number — DR. JOSEPH H SATURLEY PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SATURLEY
Provider First Name:
JOSEPH
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1225068331
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3974 TAMPA RD
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
OLDSMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34677-3228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-726-1013
Provider Business Mailing Address Fax Number:
727-796-4091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7012 ASHE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAXHAW
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28173-9574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-560-2562
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2006

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: 103T00000X , with the licence number:  PY0005438 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 6153 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 102744500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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