Provider Demographics
NPI:1205835709
Name:BOONE, JOY LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LOUISE
Last Name:BOONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:SUITE 9055 FORBES TOWER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:2347 5TH AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-1126
Practice Address - Country:US
Practice Address - Phone:412-673-5504
Practice Address - Fax:412-673-2150
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038528E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427335181OtherCBQ
1427335140OtherWHITERIVER
PA104152OtherUPMC
PA000067334OtherHIGHMARK
PA0473267OtherAETNA
PA0010874730002Medicaid
PA1409575OtherUNITED MINE WORKERS
PA104152OtherUPMC
PAC32208Medicare UPIN
PA1409575OtherUNITED MINE WORKERS