MEDICARE: DR. JOYCE HOUSTON POAG M.D.

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
1	208VP0000X	Pain Medicine Physician	21355	GA

General Provider Information

NPI Number	:	1437374519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOYCE HOUSTON POAG M.D.

Provider Business Mailing Address
First Line	:	5400 LAUREL SPRINGS PKWY
Second Line	:	SUITE 1002
City	:	SUWANEE
State	:	GA
Zip	:	30024-6056
Country	:	US
Telephone Number	:	770-888-8999
Fax Number	:	770-888-8913

Provider Business Practice Location Address
First Line	:	5400 LAUREL SPRINGS PKWY
Second Line	:	SUITE 1002
City	:	SUWANEE
State	:	GA
Zip	:	30024-6056
Country	:	US
Telephone Number	:	770-888-8999
Fax Number	:	770-888-8913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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