Provider Demographics
NPI:1427229236
Name:KRUEGER, JAMES H
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-1633
Mailing Address - Country:US
Mailing Address - Phone:573-818-9693
Mailing Address - Fax:
Practice Address - Street 1:206 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-1633
Practice Address - Country:US
Practice Address - Phone:573-818-9693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0522460001Medicare NSC