Lawrence Konick, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD17760 Issued in OR

Practice address

665 Winter Street
Salem, OR 97301-3934

Phone

(503) 561-5564

Fax

(503) 561-4781

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1538220116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 WINTER STREET",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013934",
            "telephone_number": "503-561-5564",
            "fax_number": "503-561-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONICK",
        "first_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "OR",
            "license": "MD-17760",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD17760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent J Koletar, MD
• Theresa Ann Kollars, LPC
• Derek Koller, M.D.
• Alexandria Mary Kolody, LPN
• Laslo Emory Kolta, M.D.
• Lisa Ann Callery Koontz, RN, LMT
• Madelyn Jo Koontz, RD, LD
• Tara Jade Koretsky, PHARM.D.
• Kori Chancellor Counseling
• Kori Chancellor Counseling

• Anatomic Pathology & Clinical Pathology Physician in Salem, OR
• Providers in Salem, OR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.