Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 029876 | TN |
NPI | 1568402048 |
---|---|
Provider Name | Dr. Joseph Vincent Pinyard JR. |
First Address | Johnson City, TN 37615 |
Second Address | Johnson City, TN 37615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 16/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1568402048 | (05) | VA |
3821556 | (05) | TN |
G65202 | (02) | TN |