Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25328 | WI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 25328 | WI |
NPI | 1427052448 |
---|---|
Provider Name | John T Kroner |
First Address | Glendale, WI 53212-1058 |
Second Address | Glendale, WI 53212-1058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 15/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200010931 | RAILROAD MEDICARE (01) | |
30810600 | (05) | WI |
B54342 | (02) |