Individual
JOSEPH GHITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 PAGODA OAK, SHAVANO PARK, TX 78230-5619
(804) 502-7363
Mailing address
PO BOX 950131, LOUISVILLE, KY 40295-0131
(502) 804-4766
(775) 852-6902
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
49963
KY
2085R0202X
Diagnostic Radiology Physician
ME106580
FL
2085R0202X
Diagnostic Radiology Physician
Primary
Q8484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002304500
—
FL
01
—
49963
KENTUCKY LICENSE
KY
01
—
ME106580
FLORIDA LICENCE
FL
01
—
Q8484
TEXAS LICENSE
TX
Enumeration date
05/18/2007
Last updated
07/10/2017
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