Healthcare Provider Details

I. General information

NPI: 1609897206
Provider Name (Legal Business Name): CHARLES ALLEN JOYNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 STONY POINT PKWY STE 120
RICHMOND VA
23235-1965
US

IV. Provider business mailing address

8001 FRANKLIN FARMS DR SUITE 130
RICHMOND VA
23229-5108
US

V. Phone/Fax

Practice location:
  • Phone: 804-323-5011
  • Fax:
Mailing address:
  • Phone: 804-521-5800
  • Fax: 804-545-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number010152908
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number0101052908
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: