Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 2021033146 | MO |
N | 207RN0300X | Nephrologist | 036-091534 | IL |
NPI | 1326010570 |
---|---|
Provider Name | Dr. Allen S Krall |
First Address | St. Louis, MO 63146 |
Second Address | St. Louis, MO 63146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 07/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-091534 | (05) | IL |
336-053087 | IL CONTROLLED SUBSTANCE (01) | IL |
BK4843428 | DEA (01) | IL |
G69912 | (02) | IL |