Provider Demographics
NPI:1710126636
Name:KRESS, SUZANNE M (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:KRESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:M
Other - Last Name:KLEIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-655-7040
Mailing Address - Fax:859-331-2021
Practice Address - Street 1:2300 CHAMBER CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:FT. MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-1686
Practice Address - Country:US
Practice Address - Phone:859-655-7040
Practice Address - Fax:859-331-2021
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00856633OtherRAILROAD MEDICARE
OH3107855Medicaid
KY7100138090Medicaid
KY7100138090Medicaid