Basic Information
| Provider Information | |||||||||
| NPI: | 1710347075 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEIN | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | JOHN | ||||||||
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| Mailing Information | |||||||||
| Address1: | BLANCHFIELD ARMY COMMUNITY HOSPITAL | ||||||||
| Address2: | 650 JOEL DRIVE | ||||||||
| City: | FT CAMPBELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707988400 | ||||||||
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| Practice Location | |||||||||
| Address1: | BLANCHFIELD ARMY COMMUNITY HOSPITAL | ||||||||
| Address2: | 650 JOEL DRIVE | ||||||||
| City: | FT CAMPBELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707988400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2016 | ||||||||
| LastUpdateDate: | 08/13/2019 | ||||||||
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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 | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 30412 | NE | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.