Healthcare Provider Details

I. General information

NPI: 1144667288
Provider Name (Legal Business Name): JOY OSASERE IGUOBADIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 MOYE BLVD
GREENVILLE NC
27834-2849
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-2131
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-1600
  • Fax: 252-744-1115
Mailing address:
  • Phone: 615-284-7263
  • Fax: 615-284-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number56450
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number56450
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01086119A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number2022-02627
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: