Provider Demographics
NPI:1336146943
Name:KRACHT, WILLIAM GLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GLEN
Last Name:KRACHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 CLYMER RD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-3266
Mailing Address - Country:US
Mailing Address - Phone:215-536-1890
Mailing Address - Fax:215-529-9034
Practice Address - Street 1:5724 CLYMER RD
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-3266
Practice Address - Country:US
Practice Address - Phone:215-536-1890
Practice Address - Fax:215-529-9034
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2013-12-30
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
PAOS008772L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF75711Medicare UPIN