1902301567 NPI number — ERIC FRANCIS KRUMPELBECK MD

Table of content: ERIC FRANCIS KRUMPELBECK MD (NPI 1902301567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902301567 NPI number — ERIC FRANCIS KRUMPELBECK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRUMPELBECK
Provider First Name:
ERIC
Provider Middle Name:
FRANCIS
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:
1902301567
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8701 WATERTOWN PLANK ROAD
Provider Second Line Business Mailing Address:
MEDICAL COLLEGE OF WISCONSIN, GRADUATE MEDICAL EDUCATIO
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-955-4575
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
375 DIXMYTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45220-2475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-862-3452
Provider Business Practice Location Address Fax Number:
513-862-3421
Provider Enumeration Date:
03/27/2018

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 35.141649 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2565399 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com