person
Thomas A Koenig, SAC
Surgical Physician Assistant in Edgewood, Kentucky
NPI 1689678914

Thomas A Koenig is a Surgical Physician Assistant based in Edgewood, KY and is specialized in Surgical. Thomas A Koenig practices in Edgewood, KY and has the professional credentials of SAC. The NPI Number for Thomas A Koenig is 1689678914 and holds a License No. 02-296 (Kentucky).

The current practice location address for Thomas A Koenig is 560 South Loop Rd, Edgewood, KY and can be reached out via phone at 859-301-2663 and via fax at 859-301-0655.

Location: 560 South Loop Rd, Edgewood, KY, 41017-3454
person
Provider Profile Details
NPI Number
1689678914
Provider Name
Thomas A Koenig
Credential
SAC
Provider Entity Type
Individual
Gender
Male
Address
560 South Loop Rd, Edgewood, KY, 41017-3454
Phone Number
859-301-2663
Fax Number
859-301-0655
Provider Enumeration Date
06/01/2005
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
CSA98601 01 KY CHOICE CARE PROVIDER ID
institution
Provider Business Practice Location Address Details
Address
560 South Loop Rd
City
State
Zip
41017-3454
Phone Number
859-301-2663
Fax Number
859-301-0655
person
Provider Business Mailing Address Details
Address
560 South Loop Rd
City
State
Zip
41017-3454
Phone Number
859-301-2663
Fax Number
859-301-0655
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
02-296 (Kentucky)
Definition
Definition to come...
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