Provider Demographics
NPI:1851399448
Name:PREUSS, HOWARD FRED JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:FRED
Last Name:PREUSS
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3684 HIGHWAY 150
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9692
Mailing Address - Country:US
Mailing Address - Phone:812-923-9837
Mailing Address - Fax:812-923-1872
Practice Address - Street 1:3684 HIGHWAY 150
Practice Address - Street 2:SUITE 3
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9692
Practice Address - Country:US
Practice Address - Phone:812-923-9837
Practice Address - Fax:812-923-1872
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY00188213E00000X, 213EP1101X, 213ER0200X, 213ES0103X
IN07000617A213E00000X, 213EP1101X, 213ER0200X, 213ES0103X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100116360AMedicaid
KY80001886Medicaid
KYP00300362Medicare ID - Type UnspecifiedRAILROAD MEDICARE
KY0965401Medicare PIN
T34648Medicare UPIN
KY80001886Medicaid
IN480006928Medicare ID - Type UnspecifiedRAILROAD MEDICARE