Individual
WALTER F KOSCIENSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1292 TWELVE STONES XING, GOODLETTSVILLE, TN 37072-3345
(615) 851-7711
Mailing address
1292 TWELVE STONES XING, GOODLETTSVILLE, TN 37072-3345
(615) 851-7711
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02616
KY
207P00000X
Emergency Medicine Physician
2100
TN
207R00000X
Internal Medicine Physician
02616
KY
207R00000X
Internal Medicine Physician
2100
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64026164
—
KY
Enumeration date
12/04/2006
Last updated
02/20/2015
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