Individual
DR. DOUGLAS R. KOONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FACS
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101257495
VA
207T00000X
Neurological Surgery Physician
13775
OK
207T00000X
Neurological Surgery Physician
268200
NY
207T00000X
Neurological Surgery Physician
37815
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100118150A
—
OK
Enumeration date
10/11/2005
Last updated
10/15/2015
Update your record
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