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General NPI Number Information
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NPI Number | 1841299641
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Entity Type | Individual
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Provider Name | PAUL C KONITZKY DO
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Gender | Male
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 115 NOLTE DRIVE EXT
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City | KITTANNING
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State | PA
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Zip | 16201-7159
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Country | US
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Telephone | 724-545-8000
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Fax | 724-543-4370
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Provider Business Mailing Address
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Address Line | 2006 MAXWELL LN
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City | MARS
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State | PA
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Zip | 16046-2136
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Country | US
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Telephone | 724-816-1626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS012144
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License Number State | PA
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