Provider Demographics
NPI:1811516552
Name:KREMSER, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:KREMSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-558-9490
Mailing Address - Fax:502-272-5166
Practice Address - Street 1:2410 RING RD STE 100
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7960
Practice Address - Country:US
Practice Address - Phone:502-855-7325
Practice Address - Fax:502-855-7326
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY59629207R00000X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine