Provider Demographics
NPI:1912015389
Name:CUEZZE, JOY ELEANOR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:ELEANOR
Last Name:CUEZZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:E
Other - Last Name:STEINKAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 SW LONGVIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2116
Mailing Address - Country:US
Mailing Address - Phone:877-279-5960
Mailing Address - Fax:877-384-3106
Practice Address - Street 1:400 SW LONGVIEW BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2116
Practice Address - Country:US
Practice Address - Phone:877-279-5960
Practice Address - Fax:877-384-3106
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002015737207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207628405Medicaid
MO207628405Medicaid
MO000C058Medicare PIN