Provider Demographics
NPI:1477579076
Name:JOLLY, JOSEPH F (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:JOLLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1022 1ST ST N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8706
Mailing Address - Country:US
Mailing Address - Phone:205-663-9550
Mailing Address - Fax:205-620-0864
Practice Address - Street 1:1022 1ST ST N
Practice Address - Street 2:SUITE 102
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8706
Practice Address - Country:US
Practice Address - Phone:205-663-9550
Practice Address - Fax:205-620-0864
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2016-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00020801208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12-10100OtherUNITED HEALTHCARE
AL5107567OtherAETNA
AL51514832OtherBLUE CROSS BLUE SHIELD
AL009941473Medicaid
AL33674OtherHEALTHSPRING
ALG61312OtherVIVA HEALTH
AL5107567OtherAETNA