Individual
DR. CASSIDY J KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
707 W MARKET ST STE C, ATHENS, AL 35611-2463
(256) 216-6500
(256) 216-8777
Mailing address
PO BOX 630, ATHENS, AL 35612-0630
(256) 216-6500
(256) 216-8777
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.31380
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659751915
GROUP NPI
AL
Enumeration date
06/29/2010
Last updated
03/21/2025
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