Provider Demographics
NPI:1588000798
Name:KRUSE, RYAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:KRUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2701 PRAIRIE MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-8001
Mailing Address - Country:US
Mailing Address - Phone:319-467-7063
Mailing Address - Fax:319-353-6754
Practice Address - Street 1:2701 PRAIRIE MEADOW DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-8001
Practice Address - Country:US
Practice Address - Phone:319-384-7070
Practice Address - Fax:319-353-6754
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-46519207X00000X, 207XX0005X, 208100000X
MN59467208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine