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General NPI Number Information
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NPI Number | 1366852824
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Entity Type | Individual
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Provider Name | JOYCELIN F CANAVAN M.D
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 1125 ASPIRA CT
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City | MANSFIELD
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State | OH
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Zip | 44906-4125
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Country | US
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Telephone | 419-756-2122
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Fax | 419-756-3530
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Provider Business Mailing Address
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Address Line | 1125 ASPIRA CT
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City | MANSFIELD
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State | OH
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Zip | 44906-4125
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Country | US
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Telephone | 419-756-2122
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Fax | 419-756-3530
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 0437169
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 2014008708
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 129748
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License Number State | OH
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