Provider Demographics
NPI:1154323368
Name:KOREN, JONI M (DO)
Entity Type:Individual
Prefix:DR
First Name:JONI
Middle Name:M
Last Name:KOREN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:JONI
Other - Middle Name:M
Other - Last Name:O'CONNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2912 SPRINGBORO W
Mailing Address - Street 2:STE 201
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1674
Mailing Address - Country:US
Mailing Address - Phone:937-297-8999
Mailing Address - Fax:937-233-0574
Practice Address - Street 1:8701 TROY PIKE
Practice Address - Street 2:SUITE 10
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-1066
Practice Address - Country:US
Practice Address - Phone:937-237-5294
Practice Address - Fax:937-237-4748
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003916K207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH421534506041OtherCARESOURCE
OH63489OtherAETNA
OH34003916OtherMEDICAL LICENSE
OH000000227852OtherANTHEM
OH0120586OtherUNITED HEALTHCARE
OH0663956Medicaid
OHD0391605OtherHUMANA/CHOICECARE
OH080191715OtherRAILROAD MEDICARE
OHKO0579615Medicare PIN
OH080191715OtherRAILROAD MEDICARE
OH63489OtherAETNA
OHKO0579615Medicare PIN