Provider Demographics
NPI:1396746574
Name:HOOLEY-GINGRICH, JOYCE ELAINE (MD)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ELAINE
Last Name:HOOLEY-GINGRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:E
Other - Last Name:HOOLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-0069
Mailing Address - Country:US
Mailing Address - Phone:828-649-0800
Mailing Address - Fax:
Practice Address - Street 1:590 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-6807
Practice Address - Country:US
Practice Address - Phone:828-649-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94-002732080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1270767OtherUNITED HEALTHCARE
NC43555OtherBCBSNC
NC8943555Medicaid
NC8943555Medicaid