Joshua Bumgardner PA-C
Physician Assistant in Centerville, OH(View on Map)
Full Name
Joshua Bumgardner PA-C
NPI Number
1861894958
NPI Type
Individual Provider
Gender
Male
Enumeration Date
09/19/2014
Specialties
(Taxonomies)Licenses
State
Ohio
License Number
50.004139
Contact
Information
Purpose
Mailing
Location
Address
7700 WASHINGTON VILLAGE DR STE 210
7700 WASHINGTON VILLAGE DR STE 210
City
Centerville
Centerville
State
OH
OH
Postal Code
45459-4094
45459-4094
Country
US
US
Telephone Number
(937) 562-2291
(937) 562-2291
Identifiers
Identifier
0110900
000000893560
Identifier State
OH
OH
Identifier Issuer
Unknown
ANTHEM
Health Information Exchange
Endpoint Type
DIRECT
FHIR
Endpoint
jbumgardner524993@direct.ketteringhealth.org
https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Endpoint Description
Unknown
Unknown
Use
Unknown
Unknown
Content Type
Unknown
Unknown
Affiliation
N
N
Endpoint Location
7700 Washington Village Dr Ste 210Centerville, OH454594094US
7700 Washington Village Dr Ste 210Centerville, OH454594094US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/23/2020
Provider Address
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