Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 01031070 | IN |
Y | 208600000X | Surgeon | 01031070 | IN |
NPI | 1023049855 |
---|---|
Provider Name | Paul W Cronen JR. |
First Address | Evansville, IN 47732-3395 |
Second Address | Madison, IN 47250-7328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 20/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000042210 | ANTHEM BCBS (01) | IN |
020041436 | MEDICARE RAILROAD (01) | |
100148760A | (05) | IN |
1073896 | PASSPORT KY MEDICAID (01) | KY |
2435129000 | PASSPORT ADVANTAGE (01) | KY |
410005P | SIHO (01) | IN |
4370884 | AETNA (01) | |
64754906 | (05) | KY |
C69538 | (02) |