Dr. Thomas William Konowalchuk, MD, JD
General Practice in Newport, OR. Individual provider (NPI-1).
NPI number1679856439
StatusActive
Last updated in NPPESJul 23, 2020
Details
- NPI
- 1679856439
- Entity type
- Individual (NPI-1)
- Name
- Dr. Thomas William Konowalchuk
- Credential
- MD, JD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 27, 2011
- Certification date
- Jul 23, 2020
- Last updated
- Jul 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 15049 | OR | Yes |
| 208800000X | Urology | 15049 | OR |
Practice location
1070 Ne 7th DrNewport, OR 97365-2518
Phone 541-265-3804
Mailing address
1070 Ne 7th DrNewport, OR 97365-2518
Phone 541-265-3804
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