Basic Information
| Provider Information | |||||||||
| NPI: | 1760560288 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCURRY | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | BLANTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 13955 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294223955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437661936 | ||||||||
| FaxNumber: | 8437661206 | ||||||||
| Practice Location | |||||||||
| Address1: | 1481 TOBIAS GADSON BLVD | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294074794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437661936 | ||||||||
| FaxNumber: | 8437661206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 08/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 27655 | SC | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 054278 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 276551 | 05 | SC | MEDICAID |