Provider Demographics
NPI:1043298243
Name:KREBS, HENRY J III (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:J
Last Name:KREBS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 CELEBRATE LIFE PKWY
Mailing Address - Street 2:CANCER TREATMENT CENTERS OF AMERICA
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-8001
Mailing Address - Country:US
Mailing Address - Phone:770-400-6008
Mailing Address - Fax:404-355-6959
Practice Address - Street 1:600 CELEBRATE LIFE PKWY
Practice Address - Street 2:CANCER TREATMENT CENTERS OF AMERICA
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-8001
Practice Address - Country:US
Practice Address - Phone:770-400-6008
Practice Address - Fax:404-355-6959
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2021-06-23
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Provider Licenses
StateLicense IDTaxonomies
GA0275902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD33072Medicare UPIN