Provider Demographics
NPI:1043294127
Name:ROBERT KRATZ, MD
Entity type:Organization
Organization Name:ROBERT KRATZ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-525-1511
Mailing Address - Street 1:PO BOX 701613
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45270-1613
Mailing Address - Country:US
Mailing Address - Phone:513-421-3504
Mailing Address - Fax:513-231-7055
Practice Address - Street 1:7210 TURFWAY ROAD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-525-1511
Practice Address - Fax:859-347-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCK5048OtherRR MCR
KY65938854Medicaid
KY7375Medicare PIN