Provider Demographics
NPI:1588667075
Name:KRAUS, IRA H (DPM)
Entity Type:Individual
Prefix:MR
First Name:IRA
Middle Name:H
Last Name:KRAUS
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 1:900 CIRCLE 75 PKWY SE
Mailing Address - Street 2:STE. 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3035
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:2368 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4030
Practice Address - Country:US
Practice Address - Phone:706-861-6200
Practice Address - Fax:706-861-6222
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000401213ES0103X
GAPOD000658213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA561231235EMedicaid
GA561231235GMedicaid
GA561231235BMedicaid
GA561231235CMedicaid
GA561231235DMedicaid
GA561231235IMedicaid
GA561231235JMedicaid
TN3351839Medicaid
GA561231235AMedicaid
GA561231235FMedicaid
GA561231235HMedicaid
GA561231235CMedicaid
GA561231235GMedicaid
GA561231235AMedicaid
GA561231235GMedicaid