Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | MD-48465 | IA |
Y | 213ES0000X | Sports Medicine | MD-48465 | IA |
NPI | 1245516400 |
---|---|
Provider Name | Dr. Michael Keith Krill |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2011 |
Last Update Date | 13/04/2021 |