1356430151 NPI number — MR. JOSEPH MATTHEW DAY MSPT

Table of content: MR. JOSEPH MATTHEW DAY MSPT (NPI 1356430151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356430151 NPI number — MR. JOSEPH MATTHEW DAY MSPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAY
Provider First Name:
JOSEPH
Provider Middle Name:
MATTHEW
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSPT
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:
1356430151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 40277
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36640-0277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-445-9378
Provider Business Mailing Address Fax Number:
251-445-9377

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5721 USA DR N
Provider Second Line Business Practice Location Address:
HAHN 2050
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36688-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-445-9378
Provider Business Practice Location Address Fax Number:
251-445-9377
Provider Enumeration Date:
10/12/2006

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: 225100000X , with the licence number:  PT004642 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT011660 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251X0800X , with the licence number: PTH6941 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000356111 . This is a "BCBS PIN NUMBER 4831" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000277097 . This is a "BCBS PIN NUMBER 4817" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000029150W . This is a "HUMANA PIN NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0108341 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000190966 . This is a "BCBS PIN NUMBER 4810" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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