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NPI Code Detail

MEDICARE: HENRY J KREBS III M.D.

MEDICARE: HENRY J KREBS III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician027590GA

General Provider Information

NPI Number : 1043298243
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY J KREBS III M.D.
Provider Business Mailing Address
First Line : 600 CELEBRATE LIFE PKWY
Second Line : CANCER TREATMENT CENTERS OF AMERICA
City : NEWNAN
State : GA
Zip : 30265-8001
Country : US
Telephone Number : 770-400-6008
Fax Number : 404-355-6959
Provider Business Practice Location Address
First Line : 600 CELEBRATE LIFE PKWY
Second Line : CANCER TREATMENT CENTERS OF AMERICA
City : NEWNAN
State : GA
Zip : 30265-8001
Country : US
Telephone Number : 770-400-6008
Fax Number : 404-355-6959
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 06/23/2021

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