Provider Demographics
NPI:1295897528
Name:MOBLEY, JOYCE WINIFRED (MD)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:WINIFRED
Last Name:MOBLEY
Suffix:
Gender:F
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:PO BOX 2153 DEPT 40339
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35287-9387
Mailing Address - Country:US
Mailing Address - Phone:706-271-0100
Mailing Address - Fax:706-270-0487
Practice Address - Street 1:14101 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1451
Practice Address - Country:US
Practice Address - Phone:303-751-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ212712Medicaid
AZD37323Medicare UPIN
AZ212712Medicaid
AZP00393254Medicare PIN