Healthcare Provider Details

I. General information

NPI: 1770781940
Provider Name (Legal Business Name): THOMAS PATRICK KRUPICA JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

PO BOX 3297
WINCHESTER VA
22604-2497
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-8000
  • Fax: 540-536-7780
Mailing address:
  • Phone: 540-662-8336
  • Fax: 540-662-8593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number28740
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101259619
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: