Provider Demographics
NPI:1336186071
Name:KRAATZ, JAMES J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:KRAATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M452
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-6022
Mailing Address - Fax:269-341-8244
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M452
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-6022
Practice Address - Fax:269-341-8244
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040009572086S0127X, 208600000X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208835207Medicaid
MI1336186071Medicaid
MO1701301OtherUNITED HEALTHCARE
MO185372OtherBLUE SHIELD/BLUE CHOICE
MI1417961137OtherBCBSM - BRONSON
MO633995OtherHEALTHLINK
MO1701301OtherUNITED HEALTHCARE
MO208835207Medicaid
MIC97618230Medicare PIN
MO917420635Medicare PIN
MO917425236Medicare PIN
MOP00419170Medicare UPIN