Provider Demographics
NPI:1144225749
Name:KRAUSE, RICHARD D (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-4206
Mailing Address - Country:US
Mailing Address - Phone:620-793-6592
Mailing Address - Fax:620-793-5833
Practice Address - Street 1:3109 12TH ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4206
Practice Address - Country:US
Practice Address - Phone:620-793-6592
Practice Address - Fax:620-793-5833
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12-00159213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST78450Medicare UPIN
KS006737Medicare ID - Type Unspecified