Provider Demographics
NPI:1588601710
Name:DUQUETTE, JOYCE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIE
Last Name:DUQUETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:MARIE
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1825 MARTHA BERRY BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1625
Mailing Address - Country:US
Mailing Address - Phone:706-295-5331
Mailing Address - Fax:
Practice Address - Street 1:150 GENTILLY BLVD
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-8522
Practice Address - Country:US
Practice Address - Phone:770-387-9831
Practice Address - Fax:770-387-9538
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA418699416HMedicaid
I30627Medicare UPIN
GA11SCGDKMedicare PIN