Provider Demographics
NPI:1851342604
Name:GRALL, KRISTI J (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:J
Last Name:GRALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2701 E ELVIRA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706-7124
Mailing Address - Country:US
Mailing Address - Phone:520-874-3500
Mailing Address - Fax:520-874-3425
Practice Address - Street 1:2800 E AJO WAY
Practice Address - Street 2:HOSPITAL BASED @ KINO HOSPITAL
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6204
Practice Address - Country:US
Practice Address - Phone:520-874-7400
Practice Address - Fax:520-874-3425
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46792207P00000X
AZ35503207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00337338OtherRR MEDICARE
AZ111759Medicaid
AZP00337338OtherRR MEDICARE
I13614Medicare UPIN