Doctor Name: | DR. PAUL G KROUSE |
NPI Number: | 1003879149 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | SC003511L |
Business Practice Address: | 1201 Ligonier St Latrobe, PA - 156501921 |
Business Phone Number: | 7245393650 |
Business Fax Number: | 7245393433 |
Mailing Address: | Po Box 30, 1201 Ligonier St LATROBE |
State: | PA |
Postal Code: | 156500030 |
Phone Number: | 7245393650 |
Fax Number: | 7245393433 |
NPI Enumeration Date: | 04/10/2006 |
NPI Last Update Date: | 11/07/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | SC003511L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |