Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 5601A | WY |
Y | 208600000X | Surgeon | 5601A | WY |
N | 2086S0102X | Surgical Critical Care | 5601A | WY |
N | 2086S0102X | Surgical Critical Care | DR.0048663 | CO |
N | 2086S0127X | Trauma Surgeon | 5601A | WY |
N | 2086S0127X | Trauma Surgeon | DR.0048663 | CO |
NPI | 1083842389 |
---|---|
Provider Name | Dr. Thomas Orval Kraner |
First Address | Cheyenne, WY 82009-3509 |
Second Address | Cheyenne, WY 82009-3509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010004411 | BLUE SHIELD OF IDAHO (01) | |
020043846 | RAILROAD MEDICARE (01) | |
150935 | (05) | OR |
2089246 | (05) | NV |
804302400 | (05) | ID |
DJ236 | BLUE CROSS OF IDAHO (01) | |
G-07389 | (02) | ID |