Provider Demographics
NPI:1851396683
Name:JOYNER, JOHNNY BARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:BARRY
Last Name:JOYNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-1300
Mailing Address - Country:US
Mailing Address - Phone:731-285-2100
Mailing Address - Fax:731-287-4585
Practice Address - Street 1:455 E PARKVIEW ST
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3111
Practice Address - Country:US
Practice Address - Phone:731-285-2100
Practice Address - Fax:731-286-1890
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000014290207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3028551Medicare ID - Type UnspecifiedPROVIDER NUMBER