Organization
EDGAR A BOONE JOY L BOONE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR A BOONE MD (OWNER)
(724) 446-5571
Entity
Organization
Contact information
Practice address
401 CHURCH ST, HERMINIE, PA 15637-1457
(724) 446-5571
(724) 446-2151
Mailing address
401 CHURCH ST, HERMINIE, PA 15637-1457
(724) 446-5571
(724) 446-2151
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0473267
AETNA GROUP ID NUMBER
PA
01
—
1003102
GATEWAY ID NUMBER
PA
01
—
104152
UPMC ID NUMBER
PA
01
—
1409575
UMWA ID NUMBER
PA
01
—
DG3332
RAILROAD MEDICARE
PA
Enumeration date
09/30/2005
Last updated
01/24/2008
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