Provider Demographics
NPI:1194065359
Name:MISEL, JOYCE PETERSON (OD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:PETERSON
Last Name:MISEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2154
Mailing Address - Country:US
Mailing Address - Phone:740-344-1312
Mailing Address - Fax:
Practice Address - Street 1:603 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2154
Practice Address - Country:US
Practice Address - Phone:740-344-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program