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NPI Code Detail

MEDICARE: MARY E COON MD

MEDICARE: MARY E COON MD
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
1207P00000XEmergency Medicine Physician35082656COH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00294036OTHERRR MEDICARE FAIRFIELD
5P00096090OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000316949OTHERBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000386935OTHEROHBCBS FAIRFIELD

General Provider Information

NPI Number : 1740234558
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E COON MD
Provider Business Mailing Address
First Line : PO BOX 95460
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-0033
Country : US
Telephone Number : 602-581-6076
Fax Number : 602-263-1619
Provider Business Practice Location Address
First Line : 4212 N 16TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-5319
Country : US
Telephone Number : 602-263-1200
Fax Number : 602-263-1619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 03/10/2026

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Directions to “ MARY E COON MD” Practice Location

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