Provider Demographics
NPI:1841486446
Name:KROLL, JING LU (MD)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:LU
Last Name:KROLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S. POTOMAC STREET
Mailing Address - Street 2:SUITE 270
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5456
Mailing Address - Country:US
Mailing Address - Phone:303-750-1800
Mailing Address - Fax:303-750-8000
Practice Address - Street 1:1550 S. POTOMAC STREET
Practice Address - Street 2:SUITE 270
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5456
Practice Address - Country:US
Practice Address - Phone:303-750-1800
Practice Address - Fax:303-750-8000
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46051207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47888555Medicaid
COCOAAA0004Medicare PIN