Provider Demographics
NPI:1285726182
Name:JOYNER, DOUGLAS RAY (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:RAY
Last Name:JOYNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:509 SUMTER ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MONTEZUMA
Mailing Address - State:GA
Mailing Address - Zip Code:31063-1733
Mailing Address - Country:US
Mailing Address - Phone:478-472-3207
Mailing Address - Fax:478-472-3302
Practice Address - Street 1:509 SUMTER ST
Practice Address - Street 2:SUITE D
Practice Address - City:MONTEZUMA
Practice Address - State:GA
Practice Address - Zip Code:31063-1733
Practice Address - Country:US
Practice Address - Phone:478-472-3207
Practice Address - Fax:478-472-3302
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031039208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA031039OtherMEDICAL LICENSE
D29886Medicare UPIN