Provider Demographics
NPI:1871368548
Name:WARREN, JOSHUA ANDRE JR
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:ANDRE
Last Name:WARREN
Suffix:JR
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 1:6813 SUTTON DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70812-1365
Mailing Address - Country:US
Mailing Address - Phone:225-270-6531
Mailing Address - Fax:
Practice Address - Street 1:6813 SUTTON DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70812-1365
Practice Address - Country:US
Practice Address - Phone:225-270-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008918519171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor