MEDICARE: DR. DANIEL JOSEPH KROGER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3868T	OH

General Provider Information

NPI Number	:	1730242207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOSEPH KROGER O.D.

Provider Business Mailing Address
First Line	:	7322 KINGSGATE WAY
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6566
Country	:	US
Telephone Number	:	513-777-3936
Fax Number	:	513-777-4746

Provider Business Practice Location Address
First Line	:	7322 KINGSGATE WAY
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6566
Country	:	US
Telephone Number	:	513-777-3936
Fax Number	:	513-777-4746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	06/11/2012

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