Individual
THOMAS WAYNE KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8901 CARTI WAY, LITTLE ROCK, AR 72205-6523
(501) 219-8777
(501) 907-6522
Mailing address
PO BOX 55050, LITTLE ROCK, AR 72215-5050
(501) 219-8777
(501) 907-6522
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C-5925
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112961001
—
AR
Enumeration date
11/16/2005
Last updated
12/08/2015
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