MEDICARE: JOEL D MACY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35-08-0461-M	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	08018351	OTHER	OH	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000222542	OTHER	OH	ANTHEM
2	0109435	OTHER	OH	UNITED HEALTH CARE
3	97569	OTHER	OH	NATIONWIDE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	OH0036839	OTHER	OH	TRICARE/CHAMPUS
6	7572352	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1225031099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL D MACY M.D.

Provider Business Mailing Address
First Line	:	7790 DAYTON SPRINGFIELD RD STE B
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-1996
Country	:	US
Telephone Number	:	937-399-7777
Fax Number	:	937-399-6794

Provider Business Practice Location Address
First Line	:	7790 DAYTON SPRINGFIELD RD STE B
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-1996
Country	:	US
Telephone Number	:	937-340-6440
Fax Number	:	937-340-6441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/21/2022

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Directions to “ JOEL D MACY M.D.” Practice Location

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