Provider Demographics
NPI:1528146065
Name:MARVIN, JOY D (MD)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:D
Last Name:MARVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3805 E BELL RD STE 4800
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2173
Mailing Address - Country:US
Mailing Address - Phone:602-996-4747
Mailing Address - Fax:602-953-5466
Practice Address - Street 1:3805 E BELL RD STE 4800
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2173
Practice Address - Country:US
Practice Address - Phone:602-996-4747
Practice Address - Fax:602-953-5466
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-088319208600000X
WI47411208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI02120-0217Medicare PIN