Organization
KOONCE SURGICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASSIDY J KOONCE MD (PHYSICIAN)
(256) 216-6500
Entity
Organization
Contact information
Practice address
707 W MARKET ST STE C, ATHENS, AL 35611-2463
(256) 216-6500
(256) 216-8777
Mailing address
PO BOX 630, ATHENS, AL 35612-0630
(256) 216-6500
(256) 216-8777
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD31380
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376854976
NPI
AL
Enumeration date
06/02/2015
Last updated
03/21/2025
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