MEDICARE: DR. KENT MICHAEL KRUG DC, MSN, FNP-BC, NPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1078	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350013492	OTHER	AR	RAILROAD MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	44-20043	OTHER	AR	UNITED HEALTHCARE ID
3	1569200004	OTHER	AR	QUALCHOICE ID
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4212267467254300	OTHER	AR	TRICARE

General Provider Information

NPI Number	:	1255391751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENT MICHAEL KRUG DC, MSN, FNP-BC, NPC

Provider Business Mailing Address
First Line	:	801 W MAIN ST
Second Line	:
City	:	HEBER SPRINGS
State	:	AR
Zip	:	72543-2926
Country	:	US
Telephone Number	:	501-362-6859
Fax Number	:	501-362-5735

Provider Business Practice Location Address
First Line	:	801 W MAIN ST
Second Line	:
City	:	HEBER SPRINGS
State	:	AR
Zip	:	72543-2926
Country	:	US
Telephone Number	:	501-362-6859
Fax Number	:	501-362-5735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	11/10/2021

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Directions to “ DR. KENT MICHAEL KRUG DC, MSN, FNP-BC, NPC” Practice Location

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