Provider Demographics
NPI:1265689988
Name:CONYERS, JOYCELYN GOOLSBY (DPH)
Entity Type:Individual
Prefix:DR
First Name:JOYCELYN
Middle Name:GOOLSBY
Last Name:CONYERS
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 WACONDA POINT RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-5926
Mailing Address - Country:US
Mailing Address - Phone:423-344-5576
Mailing Address - Fax:423-344-0051
Practice Address - Street 1:8634 HIGHWAY 58
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-3910
Practice Address - Country:US
Practice Address - Phone:423-344-7106
Practice Address - Fax:423-326-1962
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist