Provider Demographics
NPI:1457766818
Name:MELTON, JOYCE ANN
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 N MIDVIEW RD
Mailing Address - Street 2:APT 602
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-5213
Mailing Address - Country:US
Mailing Address - Phone:804-300-7491
Mailing Address - Fax:804-300-7491
Practice Address - Street 1:6400 N MIDVIEW RD
Practice Address - Street 2:APT 602
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-5213
Practice Address - Country:US
Practice Address - Phone:804-300-7491
Practice Address - Fax:804-300-7491
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization