Basic Information
Provider Information
NPI: 1982702601
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOYCE
FirstName: GAIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 945 N 12TH ST
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532331305
CountryCode: US
TelephoneNumber: 4142192000
FaxNumber: 7635207562
Practice Location
Address1: 945 N 12TH ST
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 53233
CountryCode: US
TelephoneNumber: 4142192000
FaxNumber: 7635207562
Other Information
ProviderEnumerationDate: 09/20/2006
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0002X38400WIY Allopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine

ID Information
IDTypeStateIssuerDescription
91681330005MN MEDICAID


Home