Provider Demographics
NPI:1972826071
Name:DOUGLAS A KRAUSS INC
Entity Type:Organization
Organization Name:DOUGLAS A KRAUSS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:314-892-1442
Mailing Address - Street 1:11132 S TOWNE SQ STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7818
Mailing Address - Country:US
Mailing Address - Phone:314-892-1442
Mailing Address - Fax:314-892-4523
Practice Address - Street 1:11132 S TOWNE SQ STE 105
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7818
Practice Address - Country:US
Practice Address - Phone:314-892-1442
Practice Address - Fax:314-892-4523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00393213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
106164OtherHEALTHLINK
27002007OtherUNITED HEALTH CARE
T42870OtherMERCY HEALTH PLANS
32525OtherGROUP HEALTH PLAN
086006OtherEXCLUSIVE CHOICE
000000011740OtherESSENCE
4332751OtherAETNA
MO9850OtherBLUE CROSS BLUE SHIELD
MOT42870Medicare UPIN
32525OtherGROUP HEALTH PLAN
106164OtherHEALTHLINK
0563470001Medicare NSC
480026320Medicare PIN