Kroll, Mark R

Kroll, Mark R is an individual health care provider with primary practice located at 2253 W Mason St , Green Bay WI 54303-4706. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Kroll, Mark R can be contacted via phone (920) 327-7000.

Contact Information

Primary practice address
2253 W Mason St Green Bay WI 54303-4706
Phone: (920) 327-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 30436-21 Wisconsin
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 30436-21 Wisconsin

Profile Details

NPI number 1124030499
LBN Legal business name Kroll, Mark R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Apr 11th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124030499 NPPES
Wisconsin MEDICAID 30049600

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