Albert Samuel Koenig, III, PA
Organization Active NPI Family Medicine Physician · Fort Smith, AR
NPI 1992848162 · NPPES record last updated Jun 19, 2008
Key facts
- NPI
- 1992848162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- C4336 (AR)
- Legal business name
- ALBERT SAMUEL KOENIG, III, PA
- Practice address
- 2420 Rogers Ave
Fort Smith, AR 72901-4164 - Phone
- (479) 782-4000
- Fax
- (479) 782-0265
- NPI assigned
- Feb 15, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- ALBERT SAMUEL KOENIG, III, PA
Authorized official
- Name
- Dr. Albert Samuel Koenig III, M.D.
- Title
- Corporation President
- Phone
- (479) 782-4000
Practitioners 1
-
Albert Samuel Koenig III, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | C4336 | AR | Yes |
| Anatomic Pathology Physician |
207ZP0101X | C4336 | AR | |
| Clinical Pathology/Laboratory Medicine Physician |
207ZP0105X | C4336 | AR |
Addresses
Primary practice location
2420 Rogers Ave
Fort Smith, AR 72901-4164
Mailing address
2420 Rogers Ave
Fort Smith, AR 72901-4164
Phone (479) 782-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110246002 | Medicaid | AR | |
| 5B289 | Other | AR | ARKANSAS BLUE CROSS & BLU |
Other names
- FAMILY MEDICAL CARE
Other providers in Fort Smith, AR
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All providers in Fort Smith, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.