MEDICARE: DR. JOHN E KONKOL JR. DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	016-005253	IL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	1874	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588758791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E KONKOL JR. DPM

Provider Business Mailing Address
First Line	:	5825 CALLAGHAN RD STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1106
Country	:	US
Telephone Number	:	210-227-8700
Fax Number	:	210-348-9130

Provider Business Practice Location Address
First Line	:	215 E QUINCY ST
Second Line	:	SUITE 501
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-2039
Country	:	US
Telephone Number	:	210-299-3922
Fax Number	:	210-299-1958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/12/2025

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Directions to “ DR. JOHN E KONKOL JR. DPM” Practice Location

Language	Start Address	Practice Location

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