Dr Anna Gabriela Konicek, DO | |
126 E Homestead Dr, Basalt, CO 81621-5033 | |
(970) 989-9597 | |
Not Available |
Full Name | Dr Anna Gabriela Konicek |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 126 E Homestead Dr, Basalt, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710034236 | NPI | - | NPPES |
20A13552 | Other | CA | STATE MEDICAL LICENSE |
234719 | Other | NY | STATE LICENSE NUMBER |
45287 | Other | CO | COLORADO STATE MEDICAL LICENSE |
OS9734 | Other | FL | STATE LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | DO2023-1082 (New Mexico) | Secondary |
207Q00000X | Family Medicine | OS9734 (Florida) | Primary |
Entity Name | App Of Tennessee Ed Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003230236 PECOS PAC ID: 8123251766 Enrollment ID: O20140506000159 |
Mailing Address | Practice Location Address |
---|---|
Dr Anna Gabriela Konicek, DO Po Box 11084, Aspen, CO 81612-9659 Ph: (970) 989-9597 | Dr Anna Gabriela Konicek, DO 126 E Homestead Dr, Basalt, CO 81621-5033 Ph: (970) 989-9597 |
Mr. Timothy Richard Kruse, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 711 E Valley Rd, Unit 202c, Basalt, CO 81621 Phone: 970-927-8563 Fax: 970-300-2883 | |
Glenn E Kotz, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1450 E Valley Rd, Suite 101, Basalt, CO 81621 Phone: 970-927-6101 Fax: 970-927-6888 | |
Dr. Anneliese Heckert, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 123 Emma Rd, Basalt, CO 81621 Phone: 970-945-2840 Fax: 970-945-2893 | |
Bruce K Bowen, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1450 E Valley Rd, Suite 101, Basalt, CO 81621 Phone: 970-927-1444 |