Provider Demographics
NPI:1346223799
Name:KRAUS, STEPHEN TERRY (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:TERRY
Last Name:KRAUS
Suffix:
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 1:1415 TULANE AVE
Mailing Address - Street 2:TW-4
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2600
Mailing Address - Country:US
Mailing Address - Phone:504-988-3290
Mailing Address - Fax:504-988-6216
Practice Address - Street 1:150 S LIBERTY ST
Practice Address - Street 2:HC-62
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2618
Practice Address - Country:US
Practice Address - Phone:504-988-6300
Practice Address - Fax:504-988-6348
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0534742085R0001X
LAMD.056132085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CL3407OtherRAILROAD MEDICARE GROUP
14119OtherPEACH STATE
GA264365013AMedicaid
341219OtherWELLCARE
GRP754OtherMEDICARE GROUP
LA1316857Medicaid
P00066205OtherRAILROAD MEDICARE
GA264365013AMedicaid