Basic Information
| Provider Information | |||||||||
| NPI: | 1114902160 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALING | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | FRANK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1235 | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 476291235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128422737 | ||||||||
| FaxNumber: | 8128422751 | ||||||||
| Practice Location | |||||||||
| Address1: | 4099 GATEWAY BLVD | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 476308954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124911307 | ||||||||
| FaxNumber: | 8128422751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2005 | ||||||||
| LastUpdateDate: | 11/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | 01036700A | IN | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000374873 | 01 | IN | ANTHEM | OTHER | 100248260B | 05 | IN | MEDICAID |