Provider Demographics
NPI:1174166623
Name:SIRKIS, JOSHUA DANIEL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DANIEL
Last Name:SIRKIS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CRESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-5515
Mailing Address - Country:US
Mailing Address - Phone:479-216-2315
Mailing Address - Fax:
Practice Address - Street 1:300 CRESTWOOD CIR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-5515
Practice Address - Country:US
Practice Address - Phone:479-216-2315
Practice Address - Fax:479-413-8090
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR303127721Medicaid