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General NPI Number Information
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NPI Number | 1598739922
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Entity Type | Individual
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Provider Name | MARY BETH KRAFTY MD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 111 TONY ROW
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City | STAR JUNCTION
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State | PA
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Zip | 15482
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Country | US
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Telephone | 724-736-0601
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Fax | 724-736-0940
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Provider Business Mailing Address
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Address Line | 111 TONY ROW PO BOX 337
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City | STAR JUNCTION
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State | PA
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Zip | 15482-0337
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Country | US
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Telephone | 724-736-0601
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Fax | 724-736-0940
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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 | MD029900E
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License Number State | PA
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