Provider Demographics
NPI:1003126293
Name:WALTON K. JOYNER, JR. , MD PA
Entity Type:Organization
Organization Name:WALTON K. JOYNER, JR. , MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WALTON
Authorized Official - Middle Name:K
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:919-787-2758
Mailing Address - Street 1:3900 BROWNING PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6508
Mailing Address - Country:US
Mailing Address - Phone:919-787-2758
Mailing Address - Fax:919-787-2988
Practice Address - Street 1:3900 BROWNING PL
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6508
Practice Address - Country:US
Practice Address - Phone:919-787-2758
Practice Address - Fax:919-787-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC47568OtherBLUE CROSS BLUE SHIELD
NC8947568Medicaid
NCE48191Medicare UPIN
NC2149639DMedicare PIN