Provider Demographics
NPI:1730142845
Name:KRUPNICK, JON E JR (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:E
Last Name:KRUPNICK
Suffix:JR
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 1:10 GREENWOOD PL
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3198
Mailing Address - Country:US
Mailing Address - Phone:828-275-4506
Mailing Address - Fax:
Practice Address - Street 1:50 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-7209
Practice Address - Country:US
Practice Address - Phone:828-275-4506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC009801343207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC930069361OtherRAILROAD
SCQ0134CMedicaid
NC1160QOtherBCBS
NC891160QMedicaid
NC2261519AMedicare PIN
NC1160QOtherBCBS
SCQ0134CMedicaid