Provider Demographics
NPI:1003822529
Name:CHILD, JOYCE R (DPM)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:R
Last Name:CHILD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:508-350-2450
Mailing Address - Fax:508-350-2318
Practice Address - Street 1:1 COMPASS WAY
Practice Address - Street 2:SUITE 208
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1465
Practice Address - Country:US
Practice Address - Phone:508-350-2222
Practice Address - Fax:508-350-2316
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2148213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALX5194OtherMEDICARE PTAN
MA3021319Medicaid
MA3021319Medicaid
MAY75091Medicare ID - Type Unspecified