Provider Demographics
NPI:1730147950
Name:KROL, JOHN E (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:KROL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8902 N MERIDIAN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5307
Mailing Address - Country:US
Mailing Address - Phone:317-853-1462
Mailing Address - Fax:317-853-5111
Practice Address - Street 1:8902 N MERIDIAN ST STE 230
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5307
Practice Address - Country:US
Practice Address - Phone:317-853-1462
Practice Address - Fax:317-853-5111
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2015-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01028630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN738430OtherPTAN
C25585Medicare UPIN
IN738430OtherPTAN