Individual
JOSEPH LEE KOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 MEDICAL PKWY STE 200, CHESAPEAKE, VA 23320-4985
(757) 625-4455
(757) 625-1829
Mailing address
300 MEDICAL PKWY STE 200, CHESAPEAKE, VA 23320-4985
(757) 625-4455
(757) 625-1829
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101221499
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006105611
—
VA
01
—
140006635
RAILROAD MEDICARE
VA
01
—
149158900
US DEPT OF LABOR
—
01
—
20186
SENTARA HEALTH PLAN
—
01
—
271748
MDIPA/MAMSI
—
01
—
284493
ANTHEM BCBS
VA
01
—
5479722
ANTHEM HEALTH PLAN
—
01
—
590581A
MEDICAID OF NC
NC
Enumeration date
07/18/2005
Last updated
02/04/2022
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