1154318673 NPI number — DAVID R KRONER MD

Table of content: DAVID R KRONER MD (NPI 1154318673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154318673 NPI number — DAVID R KRONER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRONER
Provider First Name:
DAVID
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154318673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 ALICE PECK DAY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03766-2694
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-448-3121
Provider Business Mailing Address Fax Number:
603-448-7462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 ALICE PECK DAY DR UNIT A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03766-2684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-443-9572
Provider Business Practice Location Address Fax Number:
603-443-9521
Provider Enumeration Date:
09/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  7173 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30204712 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: BCBS VT . This is a "00001358" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 8952620 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: AA56755 . This is a "HARVARD PRILGRIM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1001392 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0101358Y0NH03 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020005 . This is a "MVP" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: B85960 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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