Provider Demographics
NPI:1922005941
Name:BRASFIELD, JOYCE B (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:B
Last Name:BRASFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 297
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-620-6162
Mailing Address - Fax:901-756-5564
Practice Address - Street 1:1325 EASTMORELAND AVE
Practice Address - Street 2:#150
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3519
Practice Address - Country:US
Practice Address - Phone:901-725-0648
Practice Address - Fax:901-725-1037
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN16170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3050640Medicaid
TN2577988OtherCIGNA
MS00114307Medicaid
TN010064074OtherRAILROAD MEDICARE
TN3145823OtherBCBS TN
AR96961OtherBCBS AR
LA1727679Medicaid
TN3050640Medicaid
MS00114307Medicaid