Basic Information
| Provider Information | |||||||||
| NPI: | 1861464208 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VEYS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1434 BROADRICK DR | ||||||||
| Address2: | |||||||||
| City: | DALTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307203009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062785961 | ||||||||
| FaxNumber: | 7062750280 | ||||||||
| Practice Location | |||||||||
| Address1: | 1434 BROADRICK DR | ||||||||
| Address2: | |||||||||
| City: | DALTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307203009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062785961 | ||||||||
| FaxNumber: | 7062750280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 56934 | GA | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | P00393997 | 01 | GA | RAILROAD MEDCIARE | OTHER | 328323322A | 05 | GA | MEDICAID |