Individual
RON KONECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 288-0400
(570) 288-1677
Mailing address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-5842
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD029092E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000911193
—
PA
Enumeration date
06/23/2006
Last updated
09/13/2012
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