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General NPI Number Information
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NPI Number | 1356528855
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Entity Type | Organization
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Legal Business Name | W. S. KONETZKI , M.D., P.C.
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 200 CARRAWAY DR SUITE 2
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City | WINFIELD
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State | AL
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Zip | 35594-5048
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Country | US
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Telephone | 205-487-0550
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Fax | 205-487-0553
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Provider Business Mailing Address
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Address Line | PO BOX 605
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City | WINFIELD
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State | AL
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Zip | 35594-0605
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Country | US
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Telephone | 205-487-0550
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Fax | 205-487-0553
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. WILLIAM STANLEY KONETZKI
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Credential | M.D.
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Telephone | 205-487-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 28471
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License Number State | AL
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