Healthcare Provider Details

I. General information

NPI: 1811945512
Provider Name (Legal Business Name): JOY J KINDLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 SEMINARY RD
ALEXANDRIA VA
22304-1535
US

IV. Provider business mailing address

1301 SUNSET DR STE 3
JOHNSON CITY TN
37604-7906
US

V. Phone/Fax

Practice location:
  • Phone: 703-504-3000
  • Fax:
Mailing address:
  • Phone: 423-926-4966
  • Fax: 423-926-1823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number30834
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101259312
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: