Phillip Dorian Kroll, MD

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

4301028333 Issued in MI

Practice address

555 Towner St
Ypsilanti, MI 48198-5752

Phone

(734) 544-6716

Fax

(734) 544-6732

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1699874776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 ROCK CREEK DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041864",
            "telephone_number": "734-662-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985752",
            "telephone_number": "734-544-6716",
            "fax_number": "734-544-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "PHILLIP",
        "middle_name": "DORIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MI",
            "license": "4301028333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Psychiatry Physician in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Addiction Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.