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NPI Code Detail

MEDICARE: JOHN HOBART KROUSE M.D.

MEDICARE:   JOHN HOBART KROUSE  M.D.
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
1207Y00000XOtolaryngology Physician4301079006MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619914603
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN HOBART KROUSE M.D.
Provider Business Mailing Address
First Line : PO BOX 827783
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19182-7783
Country : US
Telephone Number : 215-707-3665
Fax Number : 215-707-7523
Provider Business Practice Location Address
First Line : 3440 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5104
Country : US
Telephone Number : 215-707-3663
Fax Number : 215-707-7523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 01/19/2010

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