MEDICARE: DR. DONALD P KRATZ 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
1	207VG0400X	Gynecology Physician	MD101532	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225135171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD P KRATZ M.D.

Provider Business Mailing Address
First Line	:	1135 E LAKEWOOD ST
Second Line	:	SUITE112
City	:	SPRINGFIELD
State	:	MO
Zip	:	65810-2434
Country	:	US
Telephone Number	:	417-887-5500
Fax Number	:	417-883-8964

Provider Business Practice Location Address
First Line	:	1135 E LAKEWOOD ST
Second Line	:	SUITE112
City	:	SPRINGFIELD
State	:	MO
Zip	:	65810-2434
Country	:	US
Telephone Number	:	417-887-5500
Fax Number	:	417-883-8964

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	02/24/2015

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