Provider Demographics
NPI:1689716565
Name:TINA JOYCE DO LLC
Entity Type:Organization
Organization Name:TINA JOYCE DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA MARIE
Authorized Official - Middle Name:TRZASKA
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-375-5520
Mailing Address - Street 1:8007 AUBURN RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9600
Mailing Address - Country:US
Mailing Address - Phone:440-375-5520
Mailing Address - Fax:440-350-0955
Practice Address - Street 1:8007 AUBURN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-9600
Practice Address - Country:US
Practice Address - Phone:440-375-5520
Practice Address - Fax:440-375-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-008375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1316907827OtherNPI TINA JOYCE DO
OH2631567Medicaid
OH1124114731OtherNPI MICHELE KLINE NP
OH2631567Medicaid