Provider Demographics
NPI:1255472056
Name:KROMINGA, JAMES FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FREDERICK
Last Name:KROMINGA
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 1:723 E WINDMERE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-6367
Mailing Address - Country:US
Mailing Address - Phone:480-283-9593
Mailing Address - Fax:
Practice Address - Street 1:723 E WINDMERE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-6367
Practice Address - Country:US
Practice Address - Phone:480-283-9593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17057207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine