Provider Demographics
NPI:1851685911
Name:KRUSE, JASON PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:PAUL
Last Name:KRUSE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1415 WOODLAND AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-3203
Mailing Address - Country:US
Mailing Address - Phone:515-241-5995
Mailing Address - Fax:515-241-6576
Practice Address - Street 1:1801 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1597
Practice Address - Country:US
Practice Address - Phone:515-282-8064
Practice Address - Fax:515-282-3589
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2018-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAR9211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine