Healthcare Provider Details

I. General information

NPI: 1639174683
Provider Name (Legal Business Name): ROBERT FRANCIS JOYCE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 WINTER AVE
BIG RAPIDS MI
49307-2058
US

IV. Provider business mailing address

PO BOX 22067
LANSING MI
48909-8016
US

V. Phone/Fax

Practice location:
  • Phone: 231-592-4431
  • Fax: 231-592-4578
Mailing address:
  • Phone: 616-975-1845
  • Fax: 989-235-5154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number5101009198
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101009198
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101009198
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: