MEDICARE: LUDWIG F KRONER III MD

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
1	174400000X	Specialist	3152A	WY
2	207X00000X	Orthopaedic Surgery Physician	11130	NV

General Provider Information

NPI Number	:	1093709404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUDWIG F KRONER III MD

Provider Business Mailing Address
First Line	:	1204 HILLTOP DR
Second Line	:	SUITE 102
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-5861
Country	:	US
Telephone Number	:	307-382-5646
Fax Number	:	307-382-8467

Provider Business Practice Location Address
First Line	:	1204 HILLTOP DR
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-5861
Country	:	US
Telephone Number	:	307-382-5646
Fax Number	:	307-382-8467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	06/03/2020

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