Provider Demographics
NPI:1093724338
Name:KRAUS, ALFRED P JR (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:P
Last Name:KRAUS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HUMPHREYS CTR STE 28
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2368
Mailing Address - Country:US
Mailing Address - Phone:901-747-3501
Mailing Address - Fax:901-747-3516
Practice Address - Street 1:50 HUMPHREYS CTR STE 28
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2368
Practice Address - Country:US
Practice Address - Phone:901-747-3501
Practice Address - Fax:901-747-3516
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD10336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0016576OtherBLUE CROSS BLUE SHIELD
TN3189860Medicaid
TN3189860Medicare PIN
TN0016576OtherBLUE CROSS BLUE SHIELD