Healthcare Provider Details

I. General information

NPI: 1730181736
Provider Name (Legal Business Name): MICHAEL RUFUS JOYCE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S VAN BUREN RD SUITE D
EDEN NC
27288-5070
US

IV. Provider business mailing address

519 S VAN BUREN RD SUITE D
EDEN NC
27288-5070
US

V. Phone/Fax

Practice location:
  • Phone: 336-627-4861
  • Fax: 336-623-4411
Mailing address:
  • Phone: 336-627-4861
  • Fax: 336-623-4411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: