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Individual

DR. ROY O KROEKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
7081 N MARKS AVE 104, PMB 358, FRESNO, CA 93711-0232
(559) 432-5565
(559) 432-5255
Mailing address
7081 N MARKS AVE 104, PMB 358, FRESNO, CA 93711-0232
(559) 270-8072
(559) 201-9342

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E14010
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E14010
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
FZ216Z
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E14010
CA
01
196282200
DEPARTMENT OF LABOR
CA
01
E14010
CALIFORNIA LICENSE
CA
Enumeration date
02/19/2007
Last updated
05/13/2024
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