Healthcare Provider Details
I. General information
NPI: 1194711481
Provider Name (Legal Business Name): HARRY LEE KRAUS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2005
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 KINGS WAY SUITE 2600
WILLIAMSBURG VA
23185-2505
US
IV. Provider business mailing address
856 J CLYDE MORRIS BLVD SUITE A
NEWPORT NEWS VA
23601-1318
US
V. Phone/Fax
- Phone: 757-345-0141
- Fax: 757-253-1527
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 0101046374 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: