Provider Demographics
NPI:1609632025
Name:REMSBURG, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:REMSBURG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97TH MEDICAL GROUP
Mailing Address - Street 2:301 N FIRST ST
Mailing Address - City:ALTUS AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73523
Mailing Address - Country:US
Mailing Address - Phone:580-481-6782
Mailing Address - Fax:
Practice Address - Street 1:97TH MEDICAL GROUP
Practice Address - Street 2:301 N FIRST ST
Practice Address - City:ALTUS AFB
Practice Address - State:OK
Practice Address - Zip Code:73523
Practice Address - Country:US
Practice Address - Phone:580-481-6782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IADDS-10270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program