Individual
DR. KENNETH E KRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2860 CHANNING WAY STE 221, IDAHO FALLS, ID 83404-7541
(208) 535-4000
Mailing address
PO BOX 742337, ATLANTA, GA 30374-2337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M4522
ID
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M4522
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000246700
—
ID
Enumeration date
01/10/2007
Last updated
07/08/2022
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