Basic Information
| Provider Information | |||||||||
| NPI: | 1871596833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOYCE | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 54589 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900540589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089417450 | ||||||||
| FaxNumber: | 5089416205 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029045707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4015219700 | ||||||||
| FaxNumber: | 4013316718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 01/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 09514 | RI | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 7023147 | 05 | RI | MEDICAID | 110081521A | 05 | MA | MEDICAID | 920005160 | 01 | RI | RR MEDICARE | OTHER |