Provider Demographics
NPI:1760560288
Name:SCURRY, JOY BLANTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:BLANTON
Last Name:SCURRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 13955
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29422-3955
Mailing Address - Country:US
Mailing Address - Phone:843-766-1936
Mailing Address - Fax:843-766-1206
Practice Address - Street 1:1481 TOBIAS GADSON BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4794
Practice Address - Country:US
Practice Address - Phone:843-766-1936
Practice Address - Fax:843-766-1206
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC27655207Q00000X
GA054278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC276551Medicaid
SCI65714Medicare UPIN
SC276551Medicaid
SC7036Medicare PIN