Provider Demographics
NPI:1831432681
Name:KRUPKO, THOMAS ALBERT (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALBERT
Last Name:KRUPKO
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 1:740 S LIMESTONE STREET KENTUCKY CLINIC SUITE K401
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-218-3055
Mailing Address - Fax:859-323-2412
Practice Address - Street 1:740 S LIMESTONE STREET KENTUCKY CLINIC SUITE K401
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-218-3055
Practice Address - Fax:859-323-2412
Is Sole Proprietor?:No
Enumeration Date:2013-03-30
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51061207XX0801X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program