Healthcare Provider Details

I. General information

NPI: 1568402048
Provider Name (Legal Business Name): JOSEPH VINCENT PINYARD JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 BOONES STATION RD
JOHNSON CITY TN
37615
US

IV. Provider business mailing address

880 BOONES STATION RD
JOHNSON CITY TN
37615
US

V. Phone/Fax

Practice location:
  • Phone: 423-722-3100
  • Fax: 423-722-3104
Mailing address:
  • Phone: 423-722-3100
  • Fax: 423-722-3104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number029876
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: