Organization
KOENIG HEALTHCARE EDMOND PLLC
Active
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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