Organization
ALBERT SAMUEL KOENIG, III, PA
Active
Parent organization
ALBERT SAMUEL KOENIG, III, PA
Other names
FAMILY MEDICAL CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALBERT SAMUEL KOENIG, III, PA
Authorized official
DR. ALBERT SAMUEL KOENIG III M.D. (CORPORATION PRESIDENT)
(479) 782-4000
Entity
Organization
Contact information
Practice address
2420 ROGERS AVE, FORT SMITH, AR 72901-4164
(479) 782-4000
(479) 782-0265
Mailing address
2420 ROGERS AVE, FORT SMITH, AR 72901-4164
(479) 782-4000
(479) 782-0265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4336
AR
207ZP0101X
Anatomic Pathology Physician
C4336
AR
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
C4336
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110246002
—
AR
01
—
5B289
ARKANSAS BLUE CROSS & BLU
AR
Enumeration date
02/15/2007
Last updated
06/19/2008
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