Individual
DR. ALBERT SAMUEL KOENIG III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2420 ROGERS AVE, FORT SMITH, AR 72901-4164
(479) 782-4000
(479) 782-0267
Mailing address
2420 ROGERS AVE, FORT SMITH, AR 72901-4164
(479) 782-4000
(479) 782-0267
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4336
AR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
C4336
AR
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
C4336
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52965
BLUE CROSS BLUE SHIELD ID
AR
Enumeration date
07/13/2005
Last updated
07/18/2007
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