MEDICARE: DR. JODY KRUKOWSKI N.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
1	175F00000X	Naturopath	07-994	AZ

General Provider Information

NPI Number	:	1164629036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODY KRUKOWSKI N.M.D

Provider Business Mailing Address
First Line	:	10416 CONSER ST APT 1D1
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66212-2632
Country	:	US
Telephone Number	:	602-320-2990
Fax Number	:	816-471-7225

Provider Business Practice Location Address
First Line	:	1810 SUMMIT ST # 101
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2109
Country	:	US
Telephone Number	:	816-471-7227
Fax Number	:	816-471-7225

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	02/26/2010

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