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Organization

C. SCOTT KOENIG

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. COREY SCOTT KOENIG (PHYSICIAN)
(508) 764-3200
Entity
Organization

Contact information

Practice address
79 SAYLES ST, SOUTHBRIDGE, MA 01550-1729
(508) 764-3200
(508) 764-9600
Mailing address
79 SAYLES ST, SOUTHBRIDGE, MA 01550-1729
(508) 764-3200
(508) 764-9600

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
72556
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3066100
MA
Enumeration date
10/07/2008
Last updated
04/07/2010
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