Provider Demographics
NPI:1093763567
Name:TAYLOR, JOY L (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
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:PO BOX 3128
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102-3128
Mailing Address - Country:US
Mailing Address - Phone:712-239-4702
Mailing Address - Fax:712-224-5898
Practice Address - Street 1:5885 SUNNYBROOK DR
Practice Address - Street 2:SUITE L-200
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4203
Practice Address - Country:US
Practice Address - Phone:712-239-4702
Practice Address - Fax:712-224-5898
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-36625207RC0000X
NE23718207RC0000X
SD5822207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAG54796Medicare UPIN
IAI17593Medicare PIN
IAI17583Medicare PIN
IAI17584Medicare PIN
IAI17586Medicare PIN
IAI17587Medicare PIN
IAI17574Medicare PIN
IAI17576Medicare PIN
IAI17580Medicare PIN
IAI17582Medicare PIN
IAI17585Medicare PIN
IAI17573Medicare PIN
IAI17589Medicare PIN
IAI17575Medicare PIN
IAI17588Medicare PIN
IAI17591Medicare PIN
NE280166Medicare PIN
IAI17581Medicare PIN
IAI17577Medicare PIN
IAI17578Medicare PIN