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General NPI Number Information
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NPI Number | 1689936775
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Entity Type | Individual
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Provider Name | KEVIN PHILLIP KRUL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 192 PARK CLUB LN STE 100
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5270
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Country | US
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Telephone | 716-204-1101
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Fax | 716-204-0914
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Provider Business Mailing Address
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Address Line | 192 PARK CLUB LN STE 120
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5270
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Country | US
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Telephone | 716-559-3803
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Fax | 716-961-4198
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 333606-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD17249
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 333606-01
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License Number State | NY
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