Provider Demographics
NPI:1851329908
Name:KRUSE, WILLIAM BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRADLEY
Last Name:KRUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2503
Mailing Address - Country:US
Mailing Address - Phone:816-842-2571
Mailing Address - Fax:
Practice Address - Street 1:UMKC SCHOOL OF MEDICINE RESIDENCY PROGRAM
Practice Address - Street 2:M1-210, 2411 HOLMES STREET
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2792
Practice Address - Country:US
Practice Address - Phone:816-235-6626
Practice Address - Fax:816-235-6629
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005012183207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine