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General NPI Number Information
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NPI Number | 1972657260
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Entity Type | Individual
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Provider Name | LONNIE JOE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 22255 GREENFIELD RD STE 280
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3712
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Country | US
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Telephone | 248-557-5227
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Fax | 248-557-1732
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Provider Business Mailing Address
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Address Line | 22255 GREENFIELD RD STE 280
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3712
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Country | US
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Telephone | 248-557-5227
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Fax | 248-557-1732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | LJ041569
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301041569
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License Number State | MI
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