Provider Demographics
NPI:1790807493
Name:KRASNER, STEPHEN N (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:N
Last Name:KRASNER
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 1:5471 N PASEO PESCADO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:888 S CRAYCROFT RD
Practice Address - Street 2:#150
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-7118
Practice Address - Country:US
Practice Address - Phone:520-747-0446
Practice Address - Fax:520-747-0416
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ208812083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine