Provider Demographics
NPI:1649256801
Name:KREBS, JOHN KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KEITH
Last Name:KREBS
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:PO BOX 932127
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0008
Mailing Address - Country:US
Mailing Address - Phone:216-241-8654
Mailing Address - Fax:
Practice Address - Street 1:2322 E 22ND ST STE 201
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3100
Practice Address - Country:US
Practice Address - Phone:216-241-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-066400207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200017599OtherRAILROAD CARE
OH0106665Medicaid
200017599OtherRAILROAD CARE
0765481Medicare PIN
0765482Medicare PIN