1326017724 NPI number — JAMES J JOYCE MD

Table of content: JAMES J JOYCE MD (NPI 1326017724)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326017724 NPI number — JAMES J JOYCE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOYCE
Provider First Name:
JAMES
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326017724
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1716 LAWRENCE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DE PERE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54115-9108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-605-3115
Provider Business Mailing Address Fax Number:
920-486-6826

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1716 LAWRENCE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DE PERE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54115-9108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-605-3115
Provider Business Practice Location Address Fax Number:
920-486-6826
Provider Enumeration Date:
03/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  23380-875 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 32662 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MR9121016357 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080195056 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4485528 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 67G60J0 . This is a "MPIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100208643 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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