Provider Demographics
NPI:1528007101
Name:CONEY, JOSEPH M (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:CONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 ENTERPRISE PKWY
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7341
Mailing Address - Country:US
Mailing Address - Phone:216-831-5700
Mailing Address - Fax:216-831-1959
Practice Address - Street 1:3401 ENTERPRISE PKWY
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7341
Practice Address - Country:US
Practice Address - Phone:216-831-5700
Practice Address - Fax:216-831-1959
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.088072207W00000X
OH35-088072207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4092182OtherBCBS
AR155119001Medicaid
4092182OtherBCBS
TN3897878Medicare ID - Type Unspecified
MS02084864Medicaid