Organization
BRUCE W KRELL DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE W KRELL DPM (PRESIDENT)
(480) 807-8532
Entity
Organization
Contact information
Practice address
2905 W WARNER RD, STE 26, CHANDLER, AZ 85224-1674
(480) 807-8532
(480) 807-0420
Mailing address
2905 W WARNER RD, STE 26, CHANDLER, AZ 85224-1674
(480) 807-8532
(480) 807-0420
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
AZ00316
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00014417
BANNER HEALTH INSURANCE
AZ
05
—
069965
—
AZ
01
—
AZ00316
STATE LICENSE
AZ
01
—
AZ0191480
BCBS AZ
AZ
Enumeration date
02/11/2008
Last updated
02/11/2008
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