Basic Information
| Provider Information | |||||||||
| NPI: | 1053410795 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KROON | ||||||||
| FirstName: | EDWIN | ||||||||
| MiddleName: | HAROLD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1103 W CAMINO MAYOR | ||||||||
| Address2: | |||||||||
| City: | GREEN VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856144725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207778271 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3601 SOUTH 6TH AVE | ||||||||
| Address2: | SOUTHERN ARIZONA VA HEALTH CARE SYSTEM | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206291814 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 14175 | CO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.