Provider Demographics
NPI:1740373661
Name:JOYCE, JASON D
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:D
Last Name:JOYCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1567 N EASTMAN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-2683
Mailing Address - Country:US
Mailing Address - Phone:423-247-0032
Mailing Address - Fax:423-247-0038
Practice Address - Street 1:1567 N EASTMAN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-2683
Practice Address - Country:US
Practice Address - Phone:423-247-0032
Practice Address - Fax:423-247-0038
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BOCO15072335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier