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DR. JOSHUA P WOLFE MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1316262280
Individual Registrant:DR. JOSHUA P WOLFE MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
233 S MAIN ST LICKING, MO 65542-0047 US
Tel: 573-674-3011 Fax: 573-674-4765
Tel: 573-674-3011 Fax: 573-674-4765
Contact information for business:
PO BOX 47 LICKING, MO 65542-0047 US
Tel: 573-674-3011 Fax: 573-674-4765
Tel: 573-674-3011 Fax: 573-674-4765
Registration Information:
NPI: 1316262280
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | MO | 2013029561 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| CLIA | 26D0679044 | MO | 01 |
| 1316262280 | MO | 05 |
