Basic Information
| Provider Information | |||||||||
| NPI: | 1710166251 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELLEN M JOYCE MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 99176 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402690176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024996189 | ||||||||
| FaxNumber: | 5024990538 | ||||||||
| Practice Location | |||||||||
| Address1: | 3500 GOOD SAMARITAN WAY | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402996117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022677403 | ||||||||
| FaxNumber: | 5022678978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2007 | ||||||||
| LastUpdateDate: | 11/01/2007 | ||||||||
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| AuthorizedOfficialLastName: | JOYCE | ||||||||
| AuthorizedOfficialFirstName: | ELLEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5024996189 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.