Koontz, Thomas J.
Koontz, Thomas J. is an individual health care provider with primary practice located at 2915 Lyndhurst Ave , Winston-Salem NC 27103-4005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Koontz, Thomas J. can be contacted via phone (336) 765-5221.Contact Information
Primary practice address
2915 Lyndhurst Ave
Winston-Salem NC 27103-4005
Phone: (336) 765-5221
Fax: (336) 765-0430
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 15108 | North Carolina |
Profile Details
NPI number | 1700845211 |
---|---|
LBN Legal business name | Koontz, Thomas J. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 22nd, 2006 |
Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700845211 | NPPES |
North Carolina | MEDICAID | 8950063 | |
North Carolina | Other | 15108 |
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