Robert Konigsberg, D.O.

Individual provider Active NPI Obstetrics & Gynecology Physician · Greenback, TN

NPI 1669880894 · NPPES record last updated Jul 31, 2014

Key facts

NPI
1669880894
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
24703 (CO)
Practice address
5425 Evergreen Farms LN
Greenback, TN 37742-3432
Phone
(303) 697-1176
NPI assigned
Jul 31, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
24703COMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 24703 CO Yes

Addresses

Primary practice location

5425 Evergreen Farms LN
Greenback, TN 37742-3432

Mailing address

5425 Evergreen Farms LN
Greenback, TN 37742-3432
Phone (303) 697-1176

Other providers in Greenback, TN

All providers in Greenback, TN · Obstetrics & Gynecology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.