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General NPI Number Information
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NPI Number | 1235766908
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Entity Type | Individual
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Provider Name | SARA JOY KRACHMALNICK MD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 7400 STATE LINE RD STE 100
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3447
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Country | US
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Telephone | 913-588-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 7400 STATE LINE RD STE 202
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3445
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Country | US
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Telephone | 913-588-6600
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Fax | 913-588-0888
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | 04-51477
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2024016919
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | 2024016919
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 04-51477
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License Number State | KS
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