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Individual

PAUL W CRONEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0840
(812) 801-0024
Mailing address
PO BOX 3395, EVANSVILLE, IN 47732-3395
(812) 801-0840
(812) 801-0025

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01031070
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000042210
ANTHEM BCBS
IN
01
020041436
MEDICARE RAILROAD
05
100148760A
IN
01
1073896
PASSPORT KY MEDICAID
KY
01
2435129000
PASSPORT ADVANTAGE
KY
01
410005P
SIHO
IN
01
4370884
AETNA
05
64754906
KY
Enumeration date
07/06/2006
Last updated
02/20/2019
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