MEDICARE: DR. JEAN YEVGENIYA KROYN DPM

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	213ES0131X	Foot Surgery Podiatrist	0604	AZ
2	213EP1101X	Primary Podiatric Medicine Podiatrist	0604	AZ

General Provider Information

NPI Number	:	1992708986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN YEVGENIYA KROYN DPM

Provider Business Mailing Address
First Line	:	PO BOX 4228
Second Line	:
City	:	COTTONWOOD
State	:	AZ
Zip	:	86326-2616
Country	:	US
Telephone Number	:	928-634-8356
Fax Number	:	928-639-2777

Provider Business Practice Location Address
First Line	:	1759 E VILLA DR
Second Line	:	STE 114
City	:	COTTONWOOD
State	:	AZ
Zip	:	86326-4681
Country	:	US
Telephone Number	:	928-634-8356
Fax Number	:	928-639-2777

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/21/2010

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