=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164594644
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOY DIERKS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/14/2006
-----------------------------------------------------
Last Update Date | 07/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | USS EMORY S LAND AS39 MEDICAL DEPARTMENT
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AE
-----------------------------------------------------
Zip | 09454
-----------------------------------------------------
Country | IT
-----------------------------------------------------
Telephone | 011390789798017
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9300 DEWITT LOOP JOINT MEDICAL READINESS CLINIC
-----------------------------------------------------
City | FORT BELVOIR
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-781-1003
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 0101238542
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2083X0100X
-----------------------------------------------------
Taxonomy Name | Occupational Medicine Physician
-----------------------------------------------------
License Number | 0101238542
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------