Provider Demographics
NPI:1427303445
Name:JOYCE, BRIAN (DPT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:JOYCE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 E INDIANA ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2794
Mailing Address - Country:US
Mailing Address - Phone:812-476-0409
Mailing Address - Fax:812-476-1016
Practice Address - Street 1:225 CROSSLAKE DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8198
Practice Address - Country:US
Practice Address - Phone:812-471-6677
Practice Address - Fax:812-474-2296
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010875A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000778678OtherBLUE CROSS BLUE SHIELD
IN000000780249OtherBLUE CROSS BLUE SHIELD
IN201129010Medicaid
IN000000786221OtherBLUE CROSS BLUE SHIELD
INP01121271Medicare UPIN
IN000000780249OtherBLUE CROSS BLUE SHIELD
IN000000786221OtherBLUE CROSS BLUE SHIELD
IN000000778678OtherBLUE CROSS BLUE SHIELD