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General NPI Number Information
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NPI Number | 1790829992
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Entity Type | Individual
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Provider Name | ROY O KROEKER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 7081 N MARKS AVE 104 PMB 358
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City | FRESNO
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State | CA
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Zip | 93711-0232
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Country | US
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Telephone | 559-432-5565
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Fax | 559-432-5255
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Provider Business Mailing Address
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Address Line | 7081 N MARKS AVE 104 PMB 358
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City | FRESNO
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State | CA
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Zip | 93711-0232
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Country | US
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Telephone | 559-270-8072
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Fax | 559-201-9342
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E14010
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E14010
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | FZ216Z
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License Number State | CA
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