Healthcare Provider Details

I. General information

NPI: 1356027528
Provider Name (Legal Business Name): ANDREW MARTIN KRALY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 10TH AVE FL 2
COLUMBUS OH
43210-1280
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9059
  • Fax: 614-293-0201
Mailing address:
  • Phone: 614-293-9059
  • Fax: 614-293-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010247RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: