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NPI Code Detail

MEDICARE: DR. MARY LYNN JOE MD

MEDICARE: DR. MARY LYNN JOE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician158702MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063402659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY LYNN JOE MD
Provider Business Mailing Address
First Line : 500 MERRIMACK ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1756
Country : US
Telephone Number : 978-557-8800
Fax Number : 978-557-8633
Provider Business Practice Location Address
First Line : 360 MERRIMACK ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1740
Country : US
Telephone Number : 978-557-8800
Fax Number : 978-557-8633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 07/21/2022

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Directions to “ DR. MARY LYNN JOE MD” Practice Location

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