Provider Demographics
NPI:1144223959
Name:KRAUSS, DOUGLAS ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ALAN
Last Name:KRAUSS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11132 S TOWNE SQ
Mailing Address - Street 2:STE 105
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7818
Mailing Address - Country:US
Mailing Address - Phone:314-892-1442
Mailing Address - Fax:314-892-4523
Practice Address - Street 1:11132 S TOWNE SQ
Practice Address - Street 2:STE 105
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7818
Practice Address - Country:US
Practice Address - Phone:314-892-1442
Practice Address - Fax:314-892-4523
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000393213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
086006OtherEXCLUSIVE CHOICE
4332751OtherAETNA
T42870OtherMERCY HEALTH PLANS
27002007OtherUNITED HEALTH CARE
32525OtherGROUP HEALTH PLAN
000000011740OtherESSENCE
MO9850OtherBLUE CROSS BLUE SHIELD
106164OtherHEALTHLINK
086006OtherEXCLUSIVE CHOICE
480026320Medicare ID - Type UnspecifiedPALMETTO GBA RAILROAD MED