Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 272171 | NY |
Y | 207RR0500X | Rheumatology | 35.134834 | OH |
N | 207RR0500X | Rheumatology | 79140 | MA |
NPI | 1023165172 |
---|---|
Provider Name | Dr. Jonathan D. Krant |
First Address | Marietta, OH 45750-0449 |
Second Address | Marietta, OH 45750-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 15/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0317272 | (05) | OH |
E34242 | (02) | MA |