Provider Demographics
NPI:1023481165
Name:KRAUTH ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:KRAUTH ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:KRAUTH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:712-730-0127
Mailing Address - Street 1:1 COLONIAL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588
Mailing Address - Country:US
Mailing Address - Phone:712-730-0127
Mailing Address - Fax:
Practice Address - Street 1:1 COLONIAL CIRCLE
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588
Practice Address - Country:US
Practice Address - Phone:712-730-0127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KRAUTH ANESTHESIA SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA38543OtherBC/BS
IA2265736Medicaid
IA14767Medicare PIN