Provider Demographics
NPI:1851300040
Name:KRAUSE, ARNOLD MELVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:MELVIN
Last Name:KRAUSE
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 1:710 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-1310
Mailing Address - Country:US
Mailing Address - Phone:270-527-9061
Mailing Address - Fax:270-527-2278
Practice Address - Street 1:710 POPLAR ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-1310
Practice Address - Country:US
Practice Address - Phone:270-527-9061
Practice Address - Fax:270-527-2278
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY61-1076248OtherEMPLOYER NUMBER
KY000000042850OtherBLUE CROSS/BLUE SHIELD
KY61-1076248OtherEMPLOYER NUMBER