Provider Demographics
NPI:1023002193
Name:JOY, GREGORY NELSON (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:NELSON
Last Name:JOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 EXECUTIVE PLAZA RD STE 5-B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8277
Mailing Address - Country:US
Mailing Address - Phone:850-462-2255
Mailing Address - Fax:850-417-8095
Practice Address - Street 1:1851 N MCKENZIE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-4704
Practice Address - Country:US
Practice Address - Phone:251-972-2020
Practice Address - Fax:315-698-0104
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216431207W00000X
AL32023207W00000X
FLME104978207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB8503Medicare PIN
NYRA4061Medicare PIN
NYRA0840Medicare PIN
G78508Medicare UPIN