Healthcare Provider Details

I. General information

NPI: 1861437741
Provider Name (Legal Business Name): PETER C KRAUSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ESPLANADE AVE SUITE 500
KENNER LA
70065-2489
US

IV. Provider business mailing address

200 W ESPLANADE AVE SUITE 500
KENNER LA
70065-2489
US

V. Phone/Fax

Practice location:
  • Phone: 504-412-1700
  • Fax: 504-412-1701
Mailing address:
  • Phone: 504-412-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number14707
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: