Basic Information
| Provider Information | |||||||||
| NPI: | 1285668640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRISTO | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 W JEFFERSON STREET | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461312732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173463883 | ||||||||
| FaxNumber: | 3173463141 | ||||||||
| Practice Location | |||||||||
| Address1: | 1155 W JEFFERSON STREET | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461312732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173463883 | ||||||||
| FaxNumber: | 3173463141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 09/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 01086525A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.