Individual
DR. JOSEPH KOENIGSMARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.,M.B.A.
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
02001067A
IN
207Q00000X
Family Medicine Physician
02001067A
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
02001067A
IN
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
02001067A
IN
208VP0000X
Pain Medicine Physician
02001067A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11452445
CAQH
KY
05
—
64021611
—
KY
Enumeration date
12/27/2006
Last updated
12/13/2022
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