| Doctor Name: | MR. JASON DAVID KRANENBURG |
| NPI Number: | 1083046635 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSA |
| License Number: | 143379 |
| Business Practice Address: | 1967 Hoods Fort Cir Nw Kennesaw, GA - 301443809 |
| Business Phone Number: | 9375702426 |
| Business Fax Number: | |
| Mailing Address: | 1967 Hoods Fort Cir Nw, KENNESAW |
| State: | GA |
| Postal Code: | 301443809 |
| Phone Number: | 9375702426 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2013 |
| NPI Last Update Date: | 02/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 143379 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |