Basic Information
| Provider Information | |||||||||
| NPI: | 1356430151 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAY | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | MATTHEW | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40277 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366400277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514459378 | ||||||||
| FaxNumber: | 2514459377 | ||||||||
| Practice Location | |||||||||
| Address1: | 5721 USA DR N | ||||||||
| Address2: | HAHN 2050 | ||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366880002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514459378 | ||||||||
| FaxNumber: | 2514459377 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 01/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT004642 | KY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT011660 | OH | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251X0800X | PTH6941 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
ID Information
| ID | Type | State | Issuer | Description | 000000356111 | 01 | OH | BCBS PIN NUMBER 4831 | OTHER | 000000277097 | 01 | OH | BCBS PIN NUMBER 4817 | OTHER | 000029150W | 01 | OH | HUMANA PIN NUMBER | OTHER | 0108341 | 05 | OH | MEDICAID | 000000190966 | 01 | OH | BCBS PIN NUMBER 4810 | OTHER |