Organization
KOENIG HEALTHCARE EDMOND PLLC
Active
Other names
Physical Medicine of Oklahoma
Organization subpart
No
Provider details
NPI number
Authorized official
BRANT THOMAS KOENIG (PRESIDENT)
(405) 726-2727
Entity
Organization
Contact information
Practice address
800 W 18TH ST STE 100, EDMOND, OK 73013-3759
(405) 726-2727
(405) 216-5724
Mailing address
800 W 18TH ST STE 100, EDMOND, OK 73013-3759
(405) 726-2727
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
385049
MEDICARE PTAN
OK
Enumeration date
05/23/2014
Last updated
02/20/2023
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