Provider Demographics
NPI:1992708986
Name:KROYN, JEAN YEVGENIYA (DPM)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:YEVGENIYA
Last Name:KROYN
Suffix:
Gender:F
Credentials:DPM
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 4228
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-2616
Mailing Address - Country:US
Mailing Address - Phone:928-634-8356
Mailing Address - Fax:928-639-2777
Practice Address - Street 1:1759 E VILLA DR
Practice Address - Street 2:STE 114
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4681
Practice Address - Country:US
Practice Address - Phone:928-634-8356
Practice Address - Fax:928-639-2777
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0604213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5713170001Medicare NSC
AZV01879Medicare UPIN
AZZ108076Medicare PIN