Provider Demographics
NPI:1366771271
Name:KRASNER, SCOTT A (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:KRASNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2655
Mailing Address - Street 2:
Mailing Address - City:CORTARO
Mailing Address - State:AZ
Mailing Address - Zip Code:85652-2655
Mailing Address - Country:US
Mailing Address - Phone:520-909-3855
Mailing Address - Fax:888-907-1710
Practice Address - Street 1:7656 N SONOMA WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-9489
Practice Address - Country:US
Practice Address - Phone:520-909-3855
Practice Address - Fax:888-907-1710
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ162692083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine