Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | TRN12440 | FL |
N | 111NI0900X | Internist | TRN12440 | FL |
N | 207W00000X | Ophthalmologist | MD157427 | OR |
NPI | 1013179274 |
---|---|
Provider Name | Helen Koenigsman |
First Address | Medford, OR 97504-8219 |
Second Address | Medford, OR 97504-8219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 21/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500647838 | (05) | OR |