Provider Demographics
NPI:1932298270
Name:KRUGLET, DONALD GALE (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:GALE
Last Name:KRUGLET
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 1:102 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-2012
Mailing Address - Country:US
Mailing Address - Phone:970-867-5681
Mailing Address - Fax:970-867-7361
Practice Address - Street 1:102 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-2012
Practice Address - Country:US
Practice Address - Phone:970-867-5681
Practice Address - Fax:970-867-7361
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01212356Medicaid
CO01212356Medicaid
C22048Medicare PIN