Provider Demographics
NPI:1689652257
Name:JOYCE, KATHLEEN MARY (MD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARY
Last Name:JOYCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MARY
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1620 SUDBURY RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-5800
Mailing Address - Country:US
Mailing Address - Phone:978-610-3611
Mailing Address - Fax:
Practice Address - Street 1:1620 SUDBURY RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-5800
Practice Address - Country:US
Practice Address - Phone:978-610-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231564207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology