Healthcare Provider Details
I. General information
NPI: 1881605681
Provider Name (Legal Business Name): JOSEPH KRYSL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
938 BANNOCK ST STE 300
DENVER CO
80204-4028
US
IV. Provider business mailing address
938 BANNOCK ST STE 300
DENVER CO
80204-4028
US
V. Phone/Fax
- Phone: 303-914-8800
- Fax: 303-716-3777
- Phone: 303-914-8800
- Fax: 303-716-3777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 34377 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: