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General NPI Number Information
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NPI Number | 1669601720
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Entity Type | Organization
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Legal Business Name | MARSHALL MEDICAL CENTER SOUTH HEATHER KRAUSSE MD
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 11491 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0136
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Country | US
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Telephone | 256-891-5102
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Fax |
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Provider Business Mailing Address
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Address Line | 227 BRITTANY RD
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-5766
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Country | US
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Telephone | 256-891-5102
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | STAN HUBBARD
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Credential |
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Telephone | 256-891-5102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD.29545
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD.29545
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License Number State | AL
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