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NPI Code Detail

MEDICARE: MRS. LAURA KOENIG M.D.

MEDICARE: MRS. LAURA KOENIG M.D.
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
1207R00000XInternal Medicine Physician38038WI

Other Identifiers

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

General Provider Information

NPI Number : 1700881869
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA KOENIG M.D.
Provider Business Mailing Address
First Line : 500 MCMILLEN ST
Second Line :
City : FORT ATKINSON
State : WI
Zip : 53538-1233
Country : US
Telephone Number : 920-563-5571
Fax Number : 920-563-7705
Provider Business Practice Location Address
First Line : 500 MCMILLEN ST
Second Line :
City : FORT ATKINSON
State : WI
Zip : 53538-1233
Country : US
Telephone Number : 920-563-5571
Fax Number : 920-563-7705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/07/2023

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Directions to “ MRS. LAURA KOENIG M.D.” Practice Location

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