Healthcare Provider Details

I. General information

NPI: 1134411234
Provider Name (Legal Business Name): RICHARD A JOYCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2011
Last Update Date: 05/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 E MAIN ST
SCOTTSVILLE VA
24590-4995
US

IV. Provider business mailing address

PO BOX 567 295 E. MAIN ST.
SCOTTSVILLE VA
24590-0567
US

V. Phone/Fax

Practice location:
  • Phone: 434-286-6434
  • Fax: 434-286-6436
Mailing address:
  • Phone: 434-286-6434
  • Fax: 434-286-6436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number0101040938
License Number StateVA

VIII. Authorized Official

Name: DR. RICHARD A JOYCE
Title or Position: OWNER
Credential: MD
Phone: 434-286-6434