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General NPI Number Information
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NPI Number | 1427582345
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Entity Type | Individual
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Provider Name | RICHARD JOHN KRETSCHMANN MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | #223-8604 GATEWAY BLVD
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City | EDMONTON
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State | ALBERTA
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Zip | T6E4B6
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Country | CA
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Telephone | 250-702-5702
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Fax |
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Provider Business Mailing Address
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Address Line | 157 KLUGE TRAIL
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City | ROCKPORT
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State | TX
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Zip | 78382
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q3906
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | Q3906
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q3906
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License Number State | TX
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