Provider Demographics
NPI:1154459402
Name:KRAUSS, DAVID M (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:KRAUSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1285
Mailing Address - Country:US
Mailing Address - Phone:541-476-4616
Mailing Address - Fax:541-476-4616
Practice Address - Street 1:1217 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1285
Practice Address - Country:US
Practice Address - Phone:541-476-4616
Practice Address - Fax:541-476-4616
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 2561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000QGFMPMedicare ID - Type Unspecified
ORUO5588Medicare UPIN