Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 0101247879 | VA |
NPI | 1023299658 |
---|---|
Provider Name | Dr. Frank Lawrence Koenig III |
First Address | Fredericksburg, VA 22408-8606 |
Second Address | Fredericksburg, VA 22401-4453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2007 |
Last Update Date | 08/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023299658 | (05) | VA |