Provider Demographics
NPI:1326077322
Name:KRATZ, LEO E (DO)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:E
Last Name:KRATZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-749-3181
Mailing Address - Fax:717-349-3191
Practice Address - Street 1:8131 SPYGLASS HILL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-5500
Practice Address - Country:US
Practice Address - Phone:717-749-3181
Practice Address - Fax:717-349-3191
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007275E207Q00000X
PAH0046721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4524533OtherAETNA
MD542611OtherCAREFIRST MD BCBS
PA14958OtherGEISINGER
MD159581400Medicaid
PA279441OtherMAMSI-WMG
PAP003002OtherGATEWAY-WMG
PA001278671Medicaid
PA104608OtherJOHNS HOPKINS
PA0504721000OtherAMERIHEALTH 65 PA
PA02023402OtherCAPITAL BLUE CROSS-WMG
PA107274OtherUNISON-WMG
PA20013075OtherAMERIHEALTH MERCY-WMG
PA671548OtherHIGHMARK BLUE SHIELD
PA671548FLTMedicare PIN
MD159581400Medicaid
PA080183529Medicare PIN