Provider Demographics
NPI:1831382472
Name:JOY FAMILY MEDICINE
Entity type:Organization
Organization Name:JOY FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-825-9900
Mailing Address - Street 1:109 N FAIRLAND ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-4203
Mailing Address - Country:US
Mailing Address - Phone:918-825-9900
Mailing Address - Fax:918-825-4341
Practice Address - Street 1:109 N FAIRLAND ST
Practice Address - Street 2:SUITE 105
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-4203
Practice Address - Country:US
Practice Address - Phone:918-825-9900
Practice Address - Fax:918-825-4341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3926207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty