Provider Demographics
NPI:1437374519
Name:POAG, JOYCE HOUSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:HOUSTON
Last Name:POAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5400 LAUREL SPRINGS PKWY
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6056
Mailing Address - Country:US
Mailing Address - Phone:770-888-8999
Mailing Address - Fax:770-888-8913
Practice Address - Street 1:5400 LAUREL SPRINGS PKWY
Practice Address - Street 2:SUITE 1002
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6056
Practice Address - Country:US
Practice Address - Phone:770-888-8999
Practice Address - Fax:770-888-8913
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA21355208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE01170Medicare UPIN