Provider Demographics
NPI:1033240023
Name:DRS CULLEN & KREILEIN, PSC, INC.
Entity Type:Organization
Organization Name:DRS CULLEN & KREILEIN, PSC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:KREILEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-441-7774
Mailing Address - Street 1:525 ALEXANDRIA PIKE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SOUTHGATE
Mailing Address - State:KY
Mailing Address - Zip Code:41071-3290
Mailing Address - Country:US
Mailing Address - Phone:859-441-7774
Mailing Address - Fax:859-441-7972
Practice Address - Street 1:525 ALEXANDRIA PIKE
Practice Address - Street 2:SUITE 220
Practice Address - City:SOUTHGATE
Practice Address - State:KY
Practice Address - Zip Code:41071-3290
Practice Address - Country:US
Practice Address - Phone:859-441-7774
Practice Address - Fax:859-441-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19552208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty