Provider Demographics
NPI:1508115130
Name:DONALD E KRING JR DO PC
Entity Type:Organization
Organization Name:DONALD E KRING JR DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/CREDENTIALING/CONTRACTING
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KURTELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-375-1550
Mailing Address - Street 1:PO BOX 3064
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81302-3064
Mailing Address - Country:US
Mailing Address - Phone:970-375-1550
Mailing Address - Fax:970-259-6555
Practice Address - Street 1:446 JENKINS RANCH RD
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6552
Practice Address - Country:US
Practice Address - Phone:970-375-1550
Practice Address - Fax:970-259-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50947174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285628016OtherNPI TYPE 1
11281142OtherCAQH NUMBER
CO50947OtherCO STATE LICENSE NUMBER