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General NPI Number Information
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NPI Number | 1063694818
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Entity Type | Organization
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Legal Business Name | PAUL G KROUSE DPM PC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 1201 LIGONIER ST
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City | LATROBE
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State | PA
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Zip | 15650-1921
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Country | US
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Telephone | 724-539-3650
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Fax | 724-539-3433
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Provider Business Mailing Address
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Address Line | 1201 LIGONIER ST PO BOX 30
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City | LATROBE
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State | PA
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Zip | 15650-1921
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Country | US
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Telephone | 724-539-3650
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Fax | 724-539-3433
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PAUL G KROUSE
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Credential |
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Telephone | 724-539-3650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC003511L
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License Number State | PA
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