Healthcare Provider Details

I. General information

NPI: 1255302972
Provider Name (Legal Business Name): KRIS FRANCIS KOBALTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 GOETHALS DRIVE SUITE 200 KADLEC CLINIC ASSOCIATED PHYSICIANS FOR WOMEN
RICHLAND WA
99352
US

IV. Provider business mailing address

3900 S ZINTEL WAY
KENNEWICK WA
99338
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-3627
  • Fax: 509-942-2340
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-942-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG69005
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60329790
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: