Provider Demographics
NPI:1194798686
Name:KROHN, KARL L (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:L
Last Name:KROHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3173
Mailing Address - Country:US
Mailing Address - Phone:936-632-8220
Mailing Address - Fax:936-632-8230
Practice Address - Street 1:10 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3173
Practice Address - Country:US
Practice Address - Phone:936-632-8220
Practice Address - Fax:936-632-8230
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098954102Medicaid
TXF47700Medicare UPIN
TXKRO86W620Medicare ID - Type Unspecified